FORM 12
Signature of third party consenting to disclosure

Reg. 21

THE REPUBLIC OF UGANDA THE ACCESS TO INFORMATION ACT,2005
THE ACCESS TO INFORMATION REGULATIONS, 2011
REPRESENTATION BY THIRD PARTY
TO: ..........................................................................

(State name of information officer and name of public body)
I .................................................................................................... (state name) of
.................................................... (state address) having received a notice from
................................................................................... (state name of public body)
on ............................. (date), as having the following interest in the record to
which access has been requested.

(state interest in the records)
The record should be disclosed because of the following reason (state reasons)

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