SCHEDULE

DECLARATION UNDER SECTION 6(1) OF THE U.P.

AGRICULTURAL CREDIT ACT, 1973
WHEREAS I, Sri Kamla Devi W/o Sundar Lal R/o - Village - Jhalaha H/o Hazipur Gang,
Pargana &Tahsil & Distt. Fatehpur is desirous of securing a sum of Rs.
(Rs Only) as financial Assistance form Panjab National
Bank,Branch-Fatehpur, Distt. Fatehpur (U.P.)
AND WHEREAS the aforesaid Bank is whiling to grant me the above amount in financial Assistance for
Propose of CROP LONG UNDER KISAN CREDIT CARD SCHEME.
I, therefore,making this declaration under sec.6(1) of the U.P. AGRICULTURAL CREDIT ACT, 1973 and bind
Myself as well, as heirs, and legel representatives by the following conditions,namely:-
1- That I am agriculturist as difined by sec.2(b) of the U.P. Agricultural Credit Act, 1973.

2- That I am the Bhumidhar/owner of the land specified below.

3- That I hereby create a charge on the said land or interest therein favor of the aforesaid bank for securing

financial Assistance form the said bank.

4- That I will repay the amount of finanicial Assistance to the bank together with interest at % per annum.

5- That if fail to make payment in the manner stated above, the properly charged may be proceeded against

and I will be lible for the costs as well as other charges and expenses of the Bank and for the costs, if any,

that the bank may have to incur for recovering the sums due.

6- That I will spent and utilize the amount of financial assistance only for the purposes share in before mentioned.

7- That the contents of this declaration are true to my personal knowledge and no part of it is false or incorrect.

Name of Name of Revenue Village in Particulars of Land Share of Borrower

Distt. Tehsil Which land is situated
Khata No. Khasra Plot No. Area in Hecyare

Fatehpur Fatehpur Kaserua, 00454 116 1.4210

126 1.2910
2 Kita- 2.7120
Share of Borrower by 0.8099
Sale deed

Total Area- 0.8090

Assessment Approximate Encumbrances Remark

Rs- /- Rs- /-
-------------------------- ------------------------
IN WITNESS WHEREOF I, hereunder set my hands this ……………day of………………..2012

Signed & DELIVERED by the above named in presence of:-

P.T.O.
 (2)

WITNESSES:
1- Name:- Signature of declarant.

S/o -

R/o -

2- Name:-

S/o - Drafted by :

R/o - (Nitai Das)

Advocate

FORWARED with compliment to the sub- registrar/Tehsildar with a request to record the Particulars of
the charges created under the declaration in his office.

Manager

Panjab National Bank,

Branch- Fatehpur, Fatehpur (U.P.)

******

RETURNED with compliments to the Manager Panjab National Bank, Branch - Fatehpur, Distt.
Fatehpur (U.P.) The charges created under the declaration has been duly failed.

Sub-Registar/Tehsildar,

Fatehpur (U.P.)

************

I do hereby certificate that Sri/Smt ……………………………………….. executive and singned/put

Impressions in my presence the witness. Sri ………………………& Sri………………………………...

Who singed the documents.

Singature of Bank Manager in whose

Presence documents were executed.