Gaya Municipat Corporation SAS Form 4 Peakeoy gore 4 icipalities in Bihar] Assessment Form for Property Tax / yacant Land Tax for Municipa (he UOT Fre samen ape ae 7 Reet PH ae ey ses) Ward Number™ Revenue Circle No.* ae vent Re sia wi" Tw Hoking Number Old Holding Namber Unique Property 1D PID) So a eat Rr wien eee afte eat wears io Type of Ownership safhea TE Single Owner {pint Owner | Parinership Form [Board] Govt. ently | Company (PviLia) ‘wr vaiot sagt wath | ech sea__| wert er | frat each HUF (Hindu Undivided Turst_— [Proprietorship Fim | Institution | NGO Authority re ae Fg Pore GARAAR | ya, frat oH ers a : ‘Oumner Details" (if more than three owners for the s: ‘wattiet ar Rae (ate yas A UR same property then please attach Annexure) Bae Y seh mies a ot ae srqerTm Ger TE) Name /Name of Company / Organization ete. Fathers Husbands’ Name / PAN Gender (MIF) h/t or aoe een ne e/a a a / ot ao we fit o/e) Property Status: suing Vacant land 7 “ae Ret fieen eae ——] Rear aft (lease iekas applicable) Mined (and + Bing (i or a agen Ge fae wt) Arr Gf +e) Rain Water Harvesting facityaviablet: Yes i wi oa das oh gitar a xi {not applicable, in case you don't own the land) GRE ores) orth sgl at ar, 7e) Property Details* 8 a1 Free Road on which Located Principal Main Road ‘Main Roa eee fer a oe (please refer Annex IV and Name of Road please tick as applicable) 3S HH Type of Use Seah ar rae (Please tick as applicable) Purely Residential yet sree (ou (7 | Perely Commercial or indus Pr aie Purely Residential and pany Commerciaiindustial ” L_] eer Acquistion! [construction of property sere ates a Prater at ah aftr erat site one aa, a steires New {rage a REN lease Tek hee) Others (please refer Annex I) oa9. Plot / Land Detail (if you own only a built portion in the form ofa flat or a floor of a building having ne ownership of land, please Gaya MuniciPl Corporation SAS Form a ren Fee wa [Solf-Assessment Form for Property Tax acant Land Tax for Municipalities in Bihar] (Bere sre unfsaraiY D ARE IMTS TUR aoe 7 Rae gf we @ fore HT) ‘Tax paymont datas (i you gavoalroadypald a Holding UX en ae arent Paper ame ge AY ear wR AT PTT fayat eh. ah) Receipt number Dato of Rayont Recall ue ‘Amount paid Payment year eee “Amount Paid Payment year agra org ar) agers ra Holding Address Correspondence Address aieet wo ara FT PIN CODE PIN CODE Contact Details vines or FT ‘Mobile Number* Phone Number rags aR Sie ae e-Mail a ‘move here)* es Ph Fe eH TH a a eT aT TT we et wT Pt ae eT er cae gp ar weer 7, BTN Tl woh w Ret eh wt)* ‘area of Plot / Land (in sa, feet) ate 79h or rT (Ut GE A) Dulltup / Constructed area on the Ground Floor (ns Bie Beas Frain (ot ge ayes fea) Built-up area in %= Constructed area on the Gr Bult are i Contd re on he round Hag and 9-8) #00 Sx 109 Toxable vacant land (In sa. fet) = Land (in Ground Floor (in sq, feet) X 1.43) sera Ro Co Ge) = A Oy | Annual vacant Land Tax (Taxable vcarg pg Arnal Yc and Toe abe ven and se ae ee a Ph re eRe ga oat) ee {| ——_—_____ J 9. feet) ~ (Constructed area on theGaya Municipay corporation — Form [Self-Assessment Form for Property es Land Tax for Municipalities in Bihar) (Rere A re Meo = fre py aah we / Rar TP we D Ferg ara) Detals of Property (I required, please attach se parate sheet sel or Rar (RE rR wh, anger ia a) Floor No. Year of Re: ea | TypeofNon | Occupancy Factor] ‘fii @ | Consructon | Nomresidenias | Comsmucion [Bultun-rea )_ Type olen, | Oecupancy Fa ey Frirerat | (RornR) | pias | Smtr da |x arandia | Tenanted (7) rar ae (et ge a) | ae ar sae | sift (ea arate (3/71) sit / fare a) 8A 98 9 a = 96 (For Floor Number: Basement 1 (erat sien: Seale 4 =~4, ie 1, Basement 2 =- 2, Ground Floor = 0, First Floor = 1, Second Floor = 2 etc) = -2,9RT = 0, sem a = 1, eita aa = 2, on) (For Construction Type - Pucca building with RCC Roof - |, pucca building with asbestos/ corrugated sheet - I, Other building - 1) (Pinter ar wea — om. A. aA we ATE aI are — 4, oR / eRres mee A VT Te TET TET — 11,97 II, 10. Details of Property (If yor property isin a multistoried building, please record here) Shel ar Reeeor (aR omer eifeser / wee feh are A el a Rawr wet eof wY) Name of Apartment Number of Flats in Apartment aa saréte 4 ae a Ee en Floor No, Residential or Non- | Construction Type | Bult up Area feat) [Type of Non Occupancy Factor Wer — [Residential (Ror NR)] Frater ar wore | ii /ftee ora | Residential Use | (self Occupied arate: ar te Sava (ri ge 8) | Aeorartha Sueir| (3)/Tenanted(T) rare (1/71) Or eR afer writ / PTR) 104 108 20) 10D 10E 10FGaya Municipal Corporation SAS Form a Raker were aa ae Bid [Self-Assessment Form for Property Tax / Vacant Land Tax for Municipalities i hae } (er Tere meer d fay e—ysaian waht we / Rat aM we @ fer Declaration: | utero (We hereby declare that the above information and property tax assessment based there on is correct to the best of my/our knowledge and belief and ie undertake to abide by the relevant provisions of the Bihar Municipal Act 2007. 87 cern ae PH seta rE te oR a Pie AA / Sl THT HB em _/ ee ee Te Pe 2o07 ah See wre or UTP we os fery aR E/E We fully understand that any information furnished above, if proved incorrect or false will render me / us fiable for penal action or other consequences as may be prescribedin Laws, Rules or Regulations framed by Govt. of Bihar or Municipality 4 / ei we wre, / aa €/ 8 a oR A ah are Gren sh we A ch /es Ren aOR oT orearferet art erg, Pram ira Fa here eros ape oR ah ae / we | Name ofthe Owner/Tax Payer wefan / eer A Signature & Date ERT TE PA Se ee Checklist of Documents tobo Attached) visa we? # fee wean! @ ara yi Registered Soe Deed 5 Hadras Tex Receipt 2 Patch peal 40. Tanmestion Certificate 3 eee aaa Deed 1. Renaty Bil 7_| Eaton Deed as. | pepe ioense aay Le | Pe