Land & Land Reforms And Refugee Relief & Rehabilitation Department
PROFORMA APPLICATION FOR MUTATION
Application No : MUTE2023131001177 Application Date : 15/02/2023
1.Particulars of the Applicant :
(a) Name :Wasim
(b) Father's/Husband's Name :Samsuddin ahmed
(c) Postal Address :Ruk
(d) Phone/Mobile No. (If Any) :9064283943
(e) Existing Khatian No. of the Applicant in the relevant :N/A
Mouza (If Any)
2.Deatils of Transfer :
(a) Mode of Transfer :Gift
(b) Registered Deed No. and Date :8853,10/02/2023
(c) Whether Transferred directly from recorded raiyat :YES
If not, state whether copies of all chain deeds are -
available with him
3. Particular of transferer:
Name :Sa
Father's/Husband's Name :Sa
Postal Address :Ruk
Name :Sa
Father's/Husband's Name :Sa
Postal Address :Ruk
Name :Sa
Father's/Husband's Name :Sa
Postal Address :Ruk
4. Land Schedule for which mutation sought for:
Police Station Mouza J.L. No. Khatian No. Plot No. Area Valid
Dhubulia Rukunpur 001 1278 215 0.7571 acre YES
Dhubulia Rukunpur 001 1278 331 0.025 acre YES
Dhubulia Rukunpur 001 1278 340 0.02 acre Exempted
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Signature of the Applicant with seal, if any
5. List of Enlosures:
15/02/2023 , 15:21:40 pm