FORM – L

See Rules 48(1)

Declaration under Section 43

I.......................................... (Age .......) Residing at……………………….. Having been admitted to the

membership of........... .. ...................... Society with Limited..............................................................being
desirous of borrowing loan from the society ................................................. liability and ………. make this
Unlimited .....................................................having borrowed loan from the society before, declaration as
required by Section 48(a)/48(b) of the Maharashtra Co-operative Societies Act. I960 , that I
own.................................. have interest as a tenant in land, land specified in the Schedule, and I hereby
create a charge on the said land...............................................Interest in favour of the society for the
payment of the may make amount of the loan which the society............................ and for all future
advances, if any, which has made the society may make to me subject to the maximum amount of
Rs…………………………. together with interest on such amount of the loan and advances.

Name of Village Name of Taluka Name of District Survey No Boundaries

City Survey No. South North

Plot Plot East West
No. Hissa
(1) (2) (3) (4) (5) (6) (7)
 Area Assessment Encumbrances, if Remarks
Approximate any if any
Acres Gunthas Rupees Naye value Nature Amount
Paise
(8) (9) (10) (11) (12) (13) (14) (15)

In witness whereof. I. Shri........................................................... Here under set my hand this

.................................... day of................................... , in the year one thousand nine hundred
and................................

Witness

Signed and delivered by the abovenamed in the presence of:-

(1)

(2)

Applicants..............................................

Signature Borrowers Attested by

Forwarded with compliments to the Village Officer with a request to include the particulars of the
charge created under the declaration in the Record of Rights and to return to the society for its record.

Chairman, Secretary

............................................. Society

Returned with compliments to the Chairman............................................ Society, Limited/Unlimited. The

charge created under the declaration is duly included in the Record of Rights on the ............. day of.
............... 19

Village Officer