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:I am glad to know that for the problems related to citizens Swaraj Kendras will be opened under
Swaraj Abhiyan. I want to help in this. I have the space for opening of the Swaraj kendras whose
details are as below:
1. /State:
2. /Assembly Constituency:
3. /Assembly no :
4. /Ward Name :
5. /Ward No. :
6. /Type of property : Commercial/ Resident/ Non-commercial
7. ( )/Carpet Area(Sq. Ft.):
8. /Floor:
9. /Nearest Place:
10. /Address :
11. /Deatils of Land Owner:
12. /Mobile No:
13. /Email:
14. ( )/Starting
members name and address of Swaraj Kendra(include a separate Sheet):
15. , /Initial source of funding and amount :
16.

(1 )/What all activities you want to carry out at your swaraj kendra,
please give brief description(1 page) :

/Date:

___________________
/Signature