Monday, April 7, 2014
Application for Land Conversion
Form of Application for Land Conversion
ANNEXURE – A
[See Rule-3(i)]
To
The Competent Authority and
Revenue Divisional Officer
_______________________Division,
_______________________ District.
Sir,
Sub: Land Conversion Act -___________________________________ Village
________________________________Mandal____________________District______
Sy.No.______________________ extent of Ac._________ Cts Conversion of Agricultural
land to Non Agricultural purpose – Requested – Regarding.
****
I,_______________________ S/o, W/o ____________________resident of ________Door. No., submit
that I am the Pattadar of Agricultural lands in S.No.________________ of ___________________village of
___________________ Mandal, ____________________District to an extent of Ac._____________Cts. I would
like to convert Agricultural land specified in the schedule into Non Agricultural purpose.
I request that the competent Authority to accord necessary permission for the conversion of
the said Agricultural land to Non Agricultural purpose in terms of section 4 of the Andhra Pradesh
Agricultural Land (Conversion for Non Agricultural purposes) Act, 2006 (A.P.Act No.3 of 2006). I
enclose herewith a copy of Challan bearing No. _____________dated___________ for Rs.__________
(Rupees ______________________________only) paid to the Government Treasury of ____________________
@ 10% basic value of the land towards conversion fee.
I hereby declare that the lands mentioned above are neither covered by any litigation / court
cases / encroachment nor this land are assigned lands/ ULS Surplus land /Agricultural Ceiling
Surplus land / Tank Bed lands.
S C H E D U L E
No.
Village & Mandal &
District Sy.No. Total extent
(S.No. wise)
Extent for which
permission for
conversion sought
Remarks
Yours faithfully,
Signature of the Applicant
Procedure: (following to be enclosed)
1)Application in prescribed format *
2)Register documents/copies of Pattadhar
Pass books/Title Deeds*
3) Basic Value certificate from Sub Registrar*
4)Ration Card/ Aadhaar No./EPIC card#
*-mandatory #-any one of them
Contact Details:
Land Line Number:
e mail id :
Mobile No:
ANNEXURE – A
[See Rule-3(i)]
To
The Competent Authority and
Revenue Divisional Officer
_______________________Division,
_______________________ District.
Sir,
Sub: Land Conversion Act -___________________________________ Village
________________________________Mandal____________________District______
Sy.No.______________________ extent of Ac._________ Cts Conversion of Agricultural
land to Non Agricultural purpose – Requested – Regarding.
****
I,_______________________ S/o, W/o ____________________resident of ________Door. No., submit
that I am the Pattadar of Agricultural lands in S.No.________________ of ___________________village of
___________________ Mandal, ____________________District to an extent of Ac._____________Cts. I would
like to convert Agricultural land specified in the schedule into Non Agricultural purpose.
I request that the competent Authority to accord necessary permission for the conversion of
the said Agricultural land to Non Agricultural purpose in terms of section 4 of the Andhra Pradesh
Agricultural Land (Conversion for Non Agricultural purposes) Act, 2006 (A.P.Act No.3 of 2006). I
enclose herewith a copy of Challan bearing No. _____________dated___________ for Rs.__________
(Rupees ______________________________only) paid to the Government Treasury of ____________________
@ 10% basic value of the land towards conversion fee.
I hereby declare that the lands mentioned above are neither covered by any litigation / court
cases / encroachment nor this land are assigned lands/ ULS Surplus land /Agricultural Ceiling
Surplus land / Tank Bed lands.
S C H E D U L E
No.
Village & Mandal &
District Sy.No. Total extent
(S.No. wise)
Extent for which
permission for
conversion sought
Remarks
Yours faithfully,
Signature of the Applicant
Procedure: (following to be enclosed)
1)Application in prescribed format *
2)Register documents/copies of Pattadhar
Pass books/Title Deeds*
3) Basic Value certificate from Sub Registrar*
4)Ration Card/ Aadhaar No./EPIC card#
*-mandatory #-any one of them
Contact Details:
Land Line Number:
e mail id :
Mobile No:
APPLICATION FOR ISSUE OF AUTHORISATION TO RUN A FAIR PRICE SHOP
ANDHRA PRADESH STATE PUBLIC DISTRIBUTION CONTROL ORDER, 2001
APPLICATION FOR ISSUE OF AUTHORISATION TO RUN A FAIR PRICE SHOP
FP Shop Details:
Shop District: ___________________________________ FP Shop Mandal: _________________________________________
FP Shop Dealer ID: ______________________________ Authorization No: __________________________________________
FP shop Address: _________________________________________________________________________________________
FP Shop Dealer Details:
Dealer Name (In Capital Letters): ____________________________________________________________________________
Father/Mother Name: ________________________________ Age & Date of Birth: ____________________________________
Caste: _________________________________________Educational Qualification: ____________________________________
Address: Door No: _____________ Locality/Landmark: ___________________________ Village: _______________________
Mandal: ______________________ District: __________________________ Pin code: _______________________
Mobile Number: _______________________ E- Mail ID: ______________________________________________
Whether he is physically handicapped (YES/No) _______________________________________________________________
Whether the applicant is connected with any other business run either by himself or by any member of his family and if so give
details__________________________________________________________________________________________________
Whether any number of the applicant’s family has been issued authorization to fair price shop earlier and if so give the details
________________________________________________________________________________________________________
Whether any of his blood relations is working in revenue/CS Dept. /CS corp. and if so give details
________________________________________________________________________________________________________
Village location, Door number, when the applicant wants to run fair price shop, if he is selected
________________________________________________________________________________________________________
Whether he can raise the sufficient funds to run fair price shop with his own funds and if so give source or whether he needs
institutional finance________________________________________________________________________________________
Whether he was convinced earlier for offence under central order issued by the State/Central under E.C
Act._____________________________________________________________________________________________________
Amount, Challan number and date through which fee for issued authorization `and application renewal has been submitted
________________________________________________________________________________________________________
I have carefully read the conditions of authorization under the Andhra Pradesh State
Distribution Control Order, 2001 and I agree to abide by them.
(a) I have not previously applied for such authorization in this district.
(b) I applied such authorization in this district on and was not granted.
(c) I hereby apply for renewal of authorization ……………………………………………………………………………………………………………
………………………………………………………………….which is enclosed.
(Strike of the Clauses not applicable)
Signature of the Applicant
Procedure (following to be enclosed):
1) Application Form* Contact Details:
2) Copy of Authorization letter* Land Line Number :
3) Latest renewed food grains and kerosene License* Mobile Number :
4) PHC Certificate (Certificate is enclosed in case he is physically handicapped). E- Mail ID :
BIRTH CERTIFICATE ISSUED BY RDO
BIRTH CERTIFICATE ISSUED BY RDO apply meeseva
To
The Revenue Divisional Officer,
___________________ Division,
___________________ District.
Respected Sir,
Sub: - Request for Issue of the Birth Certificate of my son/daughter-regarding.
I, ______________________S/O / D/O / F/O / M/O / W/O__________________,
Age ____years, occupation: _________, R/o H.No. ______, Near______________,
____________ Mandal, ________________Dist. Andhra Pradesh submit the following few lines
for your kind perusal and sympathetic favorable consideration please.
That my wife’s name is ___________________ . That my son/daughter,
___________________was born on__________ (dd/mm/yyyy) at H.No.______, Near________,
___________ Mandal/Municipality,_____________ Dist. Andhra Pradesh. The information
regarding birth of my son/daughter was not informed to the local Births and Deaths Registration
Authority of ____________Mandal/Municipality. Hence the name of my son /daughter is not
recorded in the Birth & Death Register of ______________________ Mandal/Municipality.
That my son/daughter requires birth certificate for further education urgently.
I enclosed here with Non availability certificate issued by the GP or Municipal
Commissioner, Ration card copy, SSC marks memo and Self Affidavit.
Therefore I request you kindly to issue necessary orders to Commissioner, Municipal
Council__________ to record date of birth of my son/daughter and issue Birth Certificate as
above at the earliest.
Yours faithfully,
Signature of the Applicant
Procedure: (following to be enclosed)
1) Physical Document#
2) Non availability certificate issued by the GP or
Municipal Commissioner# Land Line Number:
3) Ration card copy# Mobile No:
4) SSC marks memo# E-Mail id:
5) Self Affidavit#
*-mandatory # -any one of them
To
The Revenue Divisional Officer,
___________________ Division,
___________________ District.
Respected Sir,
Sub: - Request for Issue of the Birth Certificate of my son/daughter-regarding.
I, ______________________S/O / D/O / F/O / M/O / W/O__________________,
Age ____years, occupation: _________, R/o H.No. ______, Near______________,
____________ Mandal, ________________Dist. Andhra Pradesh submit the following few lines
for your kind perusal and sympathetic favorable consideration please.
That my wife’s name is ___________________ . That my son/daughter,
___________________was born on__________ (dd/mm/yyyy) at H.No.______, Near________,
___________ Mandal/Municipality,_____________ Dist. Andhra Pradesh. The information
regarding birth of my son/daughter was not informed to the local Births and Deaths Registration
Authority of ____________Mandal/Municipality. Hence the name of my son /daughter is not
recorded in the Birth & Death Register of ______________________ Mandal/Municipality.
That my son/daughter requires birth certificate for further education urgently.
I enclosed here with Non availability certificate issued by the GP or Municipal
Commissioner, Ration card copy, SSC marks memo and Self Affidavit.
Therefore I request you kindly to issue necessary orders to Commissioner, Municipal
Council__________ to record date of birth of my son/daughter and issue Birth Certificate as
above at the earliest.
Yours faithfully,
Signature of the Applicant
Procedure: (following to be enclosed)
1) Physical Document#
2) Non availability certificate issued by the GP or
Municipal Commissioner# Land Line Number:
3) Ration card copy# Mobile No:
4) SSC marks memo# E-Mail id:
5) Self Affidavit#
*-mandatory # -any one of them
Money Lending License hyderabad
Application form in Triplicate
Passport Size Photos - 3
Original Bank Challan
National Saving Certificate for 10,000/- in the name of Applicant / Firm
Proof ID
PAN Card
Property Documents attested
Bank A/c Statement above six months with a minimum balance of Rs 1,00,000/-
Copy of Firm Registration
Affidavit
Self-Addressed envelope, acknowledgement and affixed registered postage fee stamps
The citizen has to pay Rs. 1000/ - in the form of CHALLAN at the eSEVA Centre at the time of applying for Pawn Broking / Money Lending Fresh License.
Head of Accounts Details:
Major Head : 1475 : Other General Economic Services
Sub Major Head :
Minor Head : 200 : Regularization of other business
Group Sub Head :
Sub Head : 04 : Admn. of Money Lending Act
Detailed Head :
Sub Detailed Head :
DDO Code : 25002302001
Service Charges : The citizen has to pay Rs. 200 / - at the eSEVA Centre at the time of applying for the Fresh License.
Passport Size Photos - 3
Original Bank Challan
National Saving Certificate for 10,000/- in the name of Applicant / Firm
Proof ID
PAN Card
Property Documents attested
Bank A/c Statement above six months with a minimum balance of Rs 1,00,000/-
Copy of Firm Registration
Affidavit
Self-Addressed envelope, acknowledgement and affixed registered postage fee stamps
The citizen has to pay Rs. 1000/ - in the form of CHALLAN at the eSEVA Centre at the time of applying for Pawn Broking / Money Lending Fresh License.
Head of Accounts Details:
Major Head : 1475 : Other General Economic Services
Sub Major Head :
Minor Head : 200 : Regularization of other business
Group Sub Head :
Sub Head : 04 : Admn. of Money Lending Act
Detailed Head :
Sub Detailed Head :
DDO Code : 25002302001
Service Charges : The citizen has to pay Rs. 200 / - at the eSEVA Centre at the time of applying for the Fresh License.
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