Form 5 - MEC

REQUEST FOR INTERNAL REVIEW OF A DECISION

Part A - Particulars of the Information Seeker

Full Name *

Date of Birth

Sex

National ID Number

District

Institution

Postal Address

Physical Address

Telephone Number

Email Address

Part B - Particulars of Person on Whose Behalf the Request is Made (To be completed if a request is submitted on behalf of another person)

Full Name

Date of Birth

Sex

National ID Number

Postal Address

Physical Address

Telephone Number

Email Address

Reason(s) for Representing the Information Seeker

Part C - Summary of Request

Provide a summary of your request for information and why the information should be provided to you. Give reasons why you disagree with the decision of the information officer.

Summary of Request

Part D - Type of Assistance Requested

Describe the type of assistance that you are looking for from the Head of the Institution to whom the request for information was addressed.

Type of Assistance Requested

Attachments (Optional)

Attach copies of the following documents if available:

1. The request for information Form
2. The information officer's response to the request for access to information

Upload Supporting Documents

Maximum 5 files, 5MB each. Allowed: PDF, DOC, DOCX, JPG, PNG, GIF, TXT

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