Application to receive Information from Public Authorities (PAs)
There is no need to actually get this form from the PA if the information request substantially contain the following particulars;
Information Officer,
- Name of Requester – ……………………………………………………………………………………………………………..
- Address – …………………………………………………………………………………………………………………………….
- Contact No. (if any) -………………………………………………..…………………………………………..……………….
- Email Address (if any) – …………………………………………….…………………………………………………………..
- Details about Information requested
- Specific Public Authority ………………………………….…………..……………………..…………….………….
- Information requested ………………………………………….…………………..…………..…………….……….
- Specific period information is requested (if applicable)…………………………………..…………..……
- Manner in which information is requested– (ie would you like to-)
- inspect relevant work, documents, records
- take notes, extracts or certified copies of documents or records
- take certified samples of material
- obtain information in the form of CD/DVD/storage media/tapes/video cassettes/ any other electronic mode/ printouts where such information is stored in a computer or in any other device.
- Language in which requester prefers access -……………………………………….
- Does the information request concern the life and personal liberty of a citizen? (Yes/No)
- If Yes, give reason for belief – ……………………………………………………………
- Any other details- …………………………………………………………………………………….
- Relevant documents attached (If any)
- …………………………………………
- …………………………………………
- …………………………………………
- Is the requester a citizen of Sri Lanka? (Yes/No)
Date: –
Signature:-
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