1.
FORMAT OF INFORMATION
1. Name of Land /OCCUPATIONS WITH Detail………………………………………………………………………………
Phone No./Mobile No……………………………………..
2. Address……………………………………………………………………………………………………………………………………
PARTICULARS OF TENANTS(S) TO WHOM PREMISES LEASED OUT
1. Name ……………………………………………………………………………………………………………………………………
2. Father’s Name………………………………………………………………………………………………………………………
3. Occupation with details of office phone number………………………………………………………………………
4. …………………………………………………………………………………………………………………………………………………
5. Age……………………………….. Family members: Name Age Relationship
6. ………………………………………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………
7. Present Address: ………………………………………………………………………………………………………………………
8. Previous Residentials address …………………………………………………………………………………………………..
and telephone no. and date………………………………………………………………………………………………………
9. Permanent Address and……………………………………………………………………………………………………………
………………………………………………………………….. and Telephone Number……………………………………..
10.Details of either any one of the following passport, Driving Licence, Arms Licences, Ration
Card, Voter Card, Income Tax (Pan No.)………………………………………………………………………………………
Signature of Landlord
ACKNOWLEDGEMENT
Received from Shri/Smt……………………………………. S/o ………………………………………………………………….
R/o ……………………………………………………………………………………….. Ph. No…………………………………………
Intimation of letter out……………………………………………… to Shiri……………………………………………………..
S/o ……………………………………………………………………………………………………………………………………………….
Date Diary No. Signature of Recipient………………………………….
Name and Designation…………………………………
Police Station ………………………………………Seal