Land & Land Reforms And Refugee Relief & Rehabilitation Department
PROFORMA APPLICATION FOR MUTATION
   Application No : MUTE2025150507918                                                    Application Date : 23/05/2025
1.Particulars of the Applicant :
(a) Name                                                    :SRIBASSAHA
(b) Father's/Husband's Name                                 :LATE NIKHIL SAHA
(c) Postal Address                                          :SRIUR PURBA PARAHABRA
(d) Phone/Mobile No. (If Any)                               :8537820908
(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                            :800652,21/02/2025
(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                                                        :ANJALISAHA
Father's/Husband's Name                                     :LATE NIKHIL SAHA
Postal Address                                              :SRIPUR PURBA PARAHABRA
4. Land Schedule for which mutation sought for:
     Police Station                Mouza             J.L. No.      Khatian No.   Plot No.            Area            Valid
         Habra                   Joygachhi              079           1837         827            0.82 acre           NO
                                                                                   ___________________________________
                                                                                    Signature of the Applicant with seal, if any
5. List of Enlosures:
         - Copy / copies of registered deed.
                                                                                            06/06/2025 , 15:29:1 pm