The Kerala Chitty Rules, 1975 FORM NO.

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APPLICATION FOR PREVIOUS SANCTION TO START
AND CONDUCT A CHITTY
[Section 3 (1) and Rule 12] 1 Applicant's Name in full & Address 2 Age & Occupation 3 Amount of Chitty proposed to be conducted 4 Date of commencement and termination 5 No. of instalments & duration of the chitty 6 Place where the chitty is supposed to be conducted 7 Whether the applicant has obtained any previous sanction to start any chitties & If so give full details. 8 Nature of Security offered (if immovable furnish details) 9 Assets and Liabiltities The latest balance sheet if any should also be submitted 10 Whether the Foreman is conducting any Chitty in any other sub District & If so details 11 Whether the Foreman is disqualified under section 3(2) of the kerala Chitties Act. Place: : : : : : :

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Siganture of the Foreman

Date: Number Recommendations of the Registrar of Chitties.

S.R.O. Dated

Regitrar of Chitties Submitted to The Registrar of the District of ……………………………..

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