Professional Documents
Culture Documents
2.
3.
4.
Name of the Applicant
/
Father / Husband's Name
Residential Address
Details of Landed Property
District
Taluk
Name of the Village
Block Number
-
Town Survey Number/ Re-Survey Number
/
Name of the Local Area or Town
Name of the Street
Door No.
Lay out Plot No.
Extent
:
:
?2?
7.
?
Whether attested copy of Document are
enclosed?)
Extent
&
()
Document No. & Date
..
Sl.No
6.
?
?
Whether the Plot is Approved Lay out
or Unapproved Lay out?
(
)
Copy of Lay out Sketch should be enclosed)
:
( /
/
/
/
)
Details of Property acquired the applicant
( By the way of Legalheirshif / Partitian Deed/
Will Document / Settlement Document/
Sale Deed etc.)
Nature of Conveyance
Document
5.
-38.
?
?
(
. ()
/
/ /
/ )
Whether the Property is in possesstion of the
Applicant . If yes, specify kind of enjoyment
and evidence should be produced (i.e. Corporation
Property Tax Receipt, CMWSSB connection Card /
E.B Card/ Famil Card/ Voter list)
:
9.
? ?
Whether the property is part field or full field
10.
( / /
/ / )
If the property is part field, Specify remittance Details
of Sub-division fees Chalan No, Date,
Amount & Place and Name of the Treasury or Bank:
- Declaration
/ ////////////////////////////////////// () / //////////////////////////////////
, /
, ,
, ,
,
,
.
I ..S/O or D/O . is
hereby declare that
(1)the above mentioned particulars are correct to the best of my knowledge,
(2)the property is under my enjoyment,
(3) the Property was not acquired under Urban Land Ceiling Act
(4) the Property was not acquired by the Government for any other purpose.
(5) the patta issued based on the above particulars is liable to cancellation without prior
intimation if it is came to know as false declaration in future and legal action may be taken
against me.
-Place
-Date
:
:
Signature of Applicant