FORM 44

(See Rule 104)

(Commutation of N. A. Assessment Certificate)

This is to certify that in consideration of an amount of Rs........................ which is equal to five

times the annual non agricultural assessment of Rs...... levied or leviable in respect of the land in
Survey No.........................Village ..................................Hobli/Circle,
Taluk....................District.....................in revenue year prior to 1st April 1964 on which date he
Karnataka Land Revenue Act, 1964 came into force, having been paid to the Government of
Karnataka State under sub-section (4) of Section 83 of the said Act,
by.........................of ...........Taluk.....;...............of District.....................the Government of
Karnataka has been pleased to commute the aforesaid annual non-agricultural assessment in
respect of the said land pursuant to the Order No.....passed by the Deputy Commissioner
of..................on.................... day of.......and that on account of such commutation, the said land
shall be exempt from any non-agricultural assessment as from the revenue year, 19............in
accordance with the said provisions of the said Act.

This certificate is executed on behalf of the Government of Karnataka by the Deputy Commissioner
of.....................this...............day of.......................

19...............

Seal of the Deputy Commissioner

Deputy Commissioner