ðì¢ì£ ð ñ£ø¢øñ¢ «è£¼õîø¢è£ù õ¤í¢íð¢ð ð®õñ¢

ê£î£óí ªðòó¢ ñ£ø¢øñ¢ / àì¢ð¤ó¤¾ ñ£ø¢øñ¢

(APPLICATION FOR TRANSFER OF REGISTRY
( SIMPLE TRANSFER OR SUB DIVISION)
***

Affix here Court fee Stamp

forRs.2/-
¼.2/-è¢è£ù ï¦î¤ñù¢ø èì¢ìí
õ¤ô¢¬ô¬ò Þ颫è åì¢ì¾ñ¢
1. õ¤í¢íð¢ðî£óó¢ ªðòó¢
Name of the Applicant :

2. îèð¢ðù£ó¢ / èíõó¢ ªðòó¢

Father / Husband's Name :

3. Þ¼ð¢ð¤ì ºèõó¤
Residential Address :

4. ð ñ£ø¢øñ¢ «è£¼ñ¢ ªê£î¢¶ ðø¢ø¤ò õ¤õóñ¢

Details of Landed Property :

ñ£õì¢ìñ¢
District :

õì¢ìñ¢
Taluk :

è¤ó£ñî¢î¤ù¢ ªðòó¢
Name of the Village :

ð°î¤ âí¢
Block Number :

ïèó Ü÷¬õ âí¢ - ñÁ ï¤ô Ü÷¬õ âí¢

Town Survey Number/ Re-Survey Number :

à÷¢Ùó¢ ð°î¤ / ïèóî¢î¤ù¢ ªðòó¢

Name of the Local Area or Town :

ªî¼õ¤ù¢ ªðòó¢
Name of the Street :

èî¾ âí¢
Door No. :

ñ¬ùð¢ ð¤ó¤¾ ñ¬ù âí¢

Lay out Plot No. :
ðóð¢ð÷¾
Extent :
 ?2?

5. ñ¬ù Üçè¦èó¤è¢èð¢ðì¢ì ñ¬ùð¢ð¤ó¤¬õ

«êó¢ï¢îî£? Üô¢ô¶ Üé¢è¦èó¤è¢èð¢ðì£î ñ¬ùð¢
ð¤ó¤¬õê¢ «êó¢ï¢îî£?
Whether the Plot is Approved Lay out
or Unapproved Lay out?
(ñ¬ùð¢ ð¤ó¤¾ õ¬óðìñ¢ Þ¬íè¢èð¢ðì
«õí¢´ñ¢)
Copy of Lay out Sketch should be enclosed) :
:
6. ªê£î¢¶ ñÂî£ó袰 âõ¢õ£Á 褬ìè¢èð¢
ªðø¢ø¶ âù¢ø õ¤õóñ¢ (õ£ó¤²ó¤¬ñð¢ð® /
ð£èð¢ ð¤ó¤õ¤¬ù ðî¢î¤óð¢ð® /
àò¤ô¢ Ýõíî¢î¤ù¢ ð® / ªê좮ô¢ªñù¢ì¢
ðî¢î¤óð¢ð® / õ¤ø¢ð¬ù Íôñ¢ õ£é¢è¤ò
ðî¢î¤óð¢ð® âù¢ø õ¤õóñ¢)
Details of Property acquired the applicant
( By the way of Legalheirshif / Partitian Deed/
Will Document / Settlement Document/
Sale Deed etc.)
Block No & T.S.No. or R.S No
Ýõíî¢î¤ù¢ âí¢ ñø¢Áñ¢ ï£÷¢

Property by whom Conveyed

Property to Whom Conveyed

ð°î¤ âí¢ & ïèó Ü÷¬õ
âí¢ (Ü) ñÁ ï¤ô Ü÷¬õ
Document No. & Date
Nature of Conveyance
Ýõíî¢î¤ù¢ îù¢¬ñ

ªê£î¢¶ ò£¼è¢°
ªè£´è¢èð¢ðì¢ì¶

ªè£´è¢èð¢ðì¢ì¶
ªê£î¢¶ ò£ó£ô¢
Document

ðóð¢ð÷¾
õ.âí¢.

Extent
Sl.No

âí¢

7. ðî¢î¤ó Ýõíé¢è÷¤ù¢ ê£ù¢ø÷¤è¢èð¢ðì¢ì

ïèô¢è÷¢ Þ¬íè¢èð¢ð좴÷¢÷î£?
Whether attested copy of Document are
enclosed?)
 -3-

8. ªê£î¢¶ ñÂî£óó¤ù¢ ÜÂðõî¢î¤ô¢ à÷¢÷î£?

âõ¢õ¤îñ¢ ÜÂðõî¢î¤ô¢ à÷¢÷¶?
(Üîø¢è£ù Üî¢î£ì¢ê¤ Ýõíé¢è÷¤ù¢ ïèô¢è÷¢
Þ¬íè¢èð¢ðì «õí¢´ñ¢. (ܬõ) ñ£ïèó£ì¢ê¤
ªê£î¢¶ õó¤ ªê½î¢î¤ò óꦶ/ñ¤ù¢ èì¢ìí
Ü좬ì / °®ï¦ó¢ õ®è£ô¢ Þ¬í𢹠Ü좬ì /
°´ñ¢ð Ü좬ì / õ£è¢è£÷ó¢ Ü좬ì)
Whether the Property is in possesstion of the
Applicant . If yes, specify kind of enjoyment
and evidence should be produced (i.e. Corporation
Property Tax Receipt, CMWSSB connection Card /
E.B Card/ Famil Card/ Voter list) :

9. ð ñ£ø¢øñ¢ «è£¼ñ¢ Þìñ¢ ªê£î¢î¤ô¢ å¼

ð°î¤ò£? Üô¢ô¶ º¿¬ñò£ùî£?
Whether the property is part field or full field :

10. ð ñ£ø¢øñ¢ «è£¼ñ¢ Þìñ¢ ªê£î¢î¤ù¢ å¼

ð°î¤ò£è Þ¼ð¢ð¤ù¢ àì¢ð¤ó¤¾ èì¢ìíñ¢
ªê½î¢î¤ò õ¤õóñ¢ (êô£ù¢ âí¢ / ï£÷¢ /
ªî£¬è / ªê½î¢î¤ò õçè¤ / è¼×ôî¢î¤ù¢ ªðòó¢)
If the property is part field, Specify remittance Details
of Sub-division fees Chalan No, Date,
Amount & Place and Name of the Treasury or Bank:

àÁî¤ ªñ£ö¤ - Declaration

 / ñî¤/////////////////////////////////////î/ªð (Ü) è/ªð //////////////////////////////////

Ýè¤ò ï£ù¢ Ãø¤ò õ¤õóé¢è÷¢ ò£¾ñ¢ àí¢¬ñò£ù¬õ âù¾ñ¢, ðì¢ì£ ð ªðòó¢ ñ£ø¢øñ¢ /
àì¢ð¤ó¤¾ ñ£ø¢øñ¢ «è£¼ñ¢ ªê£î¢¶ ïèó¢¹ø ï¤ô àê¢ê õóñ¢¹ êì¢ìî¢î¤ù¢ è¦ö¢ â´è¢èð¢ðìõ¤ô¢¬ô
âù¾ñ¢, Üóê¤ù¢ ï¤ô â´ð¢¹è¢° àì¢ðì¢ìîô¢ô âù¾ñ¢, «õÁ âõ¢õ¤îñ£ù õ¤ô¢ôé¢èé¢èÀñ¢
àì¢ðì¢ìîô¢ô âù¾ñ¢, ªê£î¢¶ âù¶ ÜÂðõî¢î¤ô¢ ޼ õ¼è¤ø¶ âù¾ñ¢, ï£ù¢ Ãø¤»÷¢÷
îèõô¢è÷¤ô¢ ã«îÂñ¢ îõÁ âù ð¤ù¢ï£÷¤ô¢ ªîó¤ò õï¢î£ô¢, âù袰 õöçèð¢ð´ñ¢ ðì¢ì£õ¤¬ù
âõ¢õ¤î ºù¢ùø¤õ¤ð¢ð¤ù¢ø¤ ó ªêò¢òð¢ð´ñ¢ âù¢ð¬î»ñ¢, âù袪èî¤ó£è àó¤ò êì¢ìÌó¢õ
ïìõ®è¢¬è «ñø¢ªè£÷¢÷ð¢ð´ñ¢ âù¢ð¬î»ñ¢ ªîó¤ï¢¶ ªè£í¢«ìù¢ âù¾ñ¢ Þîù¢ Íôñ¢àÁî¤
ÃÁè¤ù¢«øù¢.
I ……………………………..S/O or D/O …………………………………………. is
hereby declare that
(1)the above mentioned particulars are correct to the best of my knowledge,
(2)the property is under my enjoyment,
(3) the Property was not acquired under Urban Land Ceiling Act
(4) the Property was not acquired by the Government for any other purpose.
(5) the patta issued based on the above particulars is liable to cancellation without prior
intimation if it is came to know as false declaration in future and legal action may be taken
against me.

Þìñ¢ -Place : ñÂî£óó¤ù¢ ¬èªò£ð¢ðñ¢

ï£÷¢ -Date : Signature of Applicant