Orissa Right to Information Forum

Form ‘A’ See Rule 4 (1)

Please be careful while filling up the form. Do not put junk characters in any of the fields below.

*First Name
Middle Name
*Last Name
Father's Name
*Permanent Address
*City/Town/G.P.
*District
*PinCode	State :
*Country
*E-mail ID
*Date of Birth	(DD/MM/YYYY format)
*Gender
*Occupation
*Whether Belongs to BPL Category
*How do you like to pay the required fees
*Education
*Name of the Office
*Subject Matter
*Information Required
Any Other Information

* Indicates mandatory field