FORM – I

( See Rule 5 (2) )

APPLICATION FOR SETTLEMENT OF LAND

To

      The Tahasildar,

1.    (a)  Name of the applicant                                        :

      (b)  Age                                                                   :

2.          Father’s name                                                    :

3.    (a)  Present residential address ( in full)                     :

      (b)  Permanent home address ( in full )                      :

4.    Caste, whether Scheduled Caste/

      Scheduled Tribe/ Others                              :

5.    Number of family members                          :

6.    Whether belongs to joint family or a

      member of single family                                :

7.    Annual Income

      (a)  From Agriculture                                               :

      (b)  From other sources                                            :

8.    Extent of land owned by him in his

      name or in the name of other members

      of his family in Urban area/ Rural area         :

9.    (a)  Occupation of the applicant                                :

      (b)  Occupation of the family members                      :

10. Detailed particulars of land applied for

      (a)  Name of village/ Urban area                               :

      (b)  Holding Number, if any                          :

      (c)  Plot Number, if any                                            :

      (d)  Area applied for                                                :

      (e)  Boundary                                                          :

11. Purpose for which the land is required          :

Dated, the                                                                       ( Signature of the applicant )

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