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FORMAT FOR INFORMATION OF TENANTS, DISTRICT LUCKNOW

1-

Name of landlord.........................................................................
Occupation with
Details office Phone No..............................................................

2-

Address ......................................................................................
Phone No. ..................................................................................

Particulars of tenant to whom premises is proposed to be or has been let out


1-

Name.................................................................Father name..................................................

2-

Occupation with details of office phone number....................................................................


.................................................................................................................................................
.................................................................................................................................................

3-

Age................. Family Members:


Name
Age Relationship
......................................................................................................................................................
......................................................................................................................................................
......................................................................................................................................................

4-

Present Address ...........................................................................................................................

5-

Previous residence address and....................................................................................................


phone No. date of leaving ...........................................................................................................

6-

Permanent address and ...............................................................................................................


phone no. .....................................................................................................................................

7-

Details of either any one of the following


Passport, Driving License, Arms License
Ration Card, Voter Card, Income Tax(Pan No.) ........................................................................
....................................................................................................................................................

Signature of landlord
...............................................................................................................................................................

ACKNOWLEDGEMENT
Receiver from Shri/Smt............................................S/o.........................................................................
R/o...............................................................................................Ph.No.................................................
Intimation of letting out.................................................to Shri..............................................................
S/o......................................................................R/o..............................................................................
Date........................Diary No...................................... Signature of Recipient......................................

Name & designation .......................................


Police Station ....................................... Seal :

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