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Request for records / archives

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To be filled by the Person making the request
Records/Archives belongings to-
Ministry/State/Division -------------------------------------------------------------------------------------------
Department/Enterprise etc. -------------------------------------------------------------------------------------
Branch/Sub-branch etc. -----------------------------------------------------------------------------------------
Date of records/archives ----------------------------------------------------------------------------------------
Records/Archives No. --------------------------------------------------------------------------------------------
Name and signature of person making the request -----------------------------------------------------------
Date of request ---------------------------------------------------------------------------------------------------

To be filled in by the official concerned

Repository/Shelf/rack No. --------------------------------------------------------------------------------------

Archives Group/series -------------------------------------------------------------------------------------------

No. of files --------------------------------------------------------------------------------------------------------

Staff Officer's remarks -------------------------------------------------------------------------------------------

To be filled in by the responsible official

Permitted/not permitted -----------------------------------------------------------------------------------------

Signature --------------------------------------