Request for Access to Information Form

BOI request form for access to information

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: REQUEST FOR ACCESS TO INFORMATION
Complete Name of the Requester:
Office Address:

Tel. No:

Home Address:

Tel. No.

Date and Time of Filing:

Email address:

Name of the entity, if request is made by a business entity or organization:
Position in the Business Organization:
Specify the requested information, official record, public record. (Requests with general
descriptions will not be accepted.)

Specify the purpose of the request.

Identify the Service or Division in possession of the requested information, if known to the
Have you filed the same request in the last 6 months?
Does the requested document contain confidential information involving third parties?
Yes __ No ___
Do you have the required authority to access the same from the concerned third party?
Yes __ No ___
Have you requested the same information from that third party? Yes ___ No__
What was the action taken by that third party? Approved__ Disapproved___
Why was it disapproved? ___________________________________________

Preferred Mode of Service of Notices and Decisions:

Electronic Mail____

Registered Mail___

Note: For requests which are granted, the BOI shall inform Requester through electronic mail of
such approval for the latter to arrange payment and pick of the documents.