| Direct Complaint with CIC |
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| Ministry/Department Details |
*mandatory |
| Union Ministry *
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| Department |
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| Enter Name of Department, if not available in the list |
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| Enter Name of Department, if not Not Known |
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| Enter Name of Department, if not available in the list |
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| Organisation/Public Authority * |
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| Enter Name of Organistation , if not available in the list |
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| Complainant's Particulars |
| Name * |
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Surname
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Alias
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| Citizenship Status * |
Indian
NRI/Persons of Indian Origin |
| Country of Residence * |
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| Is the Complainant Below Poverty Line(BPL)? * |
Yes No |
| Details of BPL Certificate/Proof |
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| Copy of BPL Certificate/Proof |
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| Contact Details |
| Complete Address * |
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| Pin/Zip/Area Code |
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| State/UT |
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| District |
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| Name of City/Town/Village |
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Telephone
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Phone1
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Phone2 |
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Mobile no
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Fax
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-
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| E-mail ID |
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| Details of PIO approached, if any |
| Have you applied to any PIO for Information related to this complaint * |
Yes
No |
| Do you have Complaint / Registration Number of your complaint |
Yes
No |
| Enter Complaint / Registration Number of your Complaint |
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| Info. Request Filed On(Date) |
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| PIO Details |
Name
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Address |
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Telephone -
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Email
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| If First Appeal made |
Yes
No |
| Do you have Complaint / Registration Number of your First Appeal |
Yes
No |
| Enter Complaint / Registration Number of your First appeal |
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| First Appeal filed on (Date) |
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| Appellate Authority Details |
Name
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Address |
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Telephone -
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Email
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| If do not have Complaint / Registration Number. give details |
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| Complaint Details |
| Does it pertain to the Life or Liberty of a Citizen?(This information is required to make the provision of Section 7(1) applicable) |
Yes (Urgent)
No (Normal) |
Are you a Senior Citizen?
(above 60 years ) |
Yes
No |
| Age Category |
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| Details of age proof document |
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| Copy of age proof document |
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| Are you Physically Handicapped? |
Yes
No |
| Details of Handicap |
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| Copy of disability certificate |
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Please enter the Complaint Description
(if you have text in electronic form simply copy and paste here) * |
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| Supporting Documents |
| Document 1* |
Detail:
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Upload:
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| Do you want to upload more documents |
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| Document 2 |
Detail:
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Upload:
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| Document 3 |
Detail:
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Upload:
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| Document 4 |
Detail:
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Upload:
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| Document 5 |
Detail:
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Upload:
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| Information for Research and Analysis Purpose |
| Above information is sufficient to file this complaint. In case you agree to help us in research, kindly choose Yes and provide the information requested in the following dropdown boxes. |
Yes
No |
| Category |
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| Sex |
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| Locality |
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| Age Category | |
| Education |
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| Occupation |
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| Annual Income |
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| Verification |
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Declaration : The information as provided above is true to the best of my knowledge and belief. |
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