GOMs59

Affix Photo of
Format
the Applicant
along with
Appendix-I his/her Spouse
Application.No:

APPLICATION FOR REGULARIZATION AND TRANSFER OF RIGHTS OF LAND

ENCROACHMENTS ON UN-OBJECTIONABLE GOVERNMENT AND SURPLUS LAND
UNDER URBAN LAND CEILING ON PAYMENT BASIS AS PER G.O.MS.NO. 59, REVENUE
(ASSN-II) DEPARTMENT, DATED: 30.12.2014.

1. Name of the occupant and his/her Spouse :

2. Father’s / Husband’s/Wife’s Name and other family :
member’s Names
3. Present Residential Address :
4. Details of the Unobjectionable Government land /Ceiling
Surplus land occupied by way of encroachment:
a). Survey No., Village / Ward No. :
b). Extent of land occupied :
c). Date from which occupied :
(Proof to be produced)
d) Proof of Identity
i. Aadhar Card,
ii. Any other document (such as voter ID
card, Driving License, Passport , Bank Pass
Book)
e). Nature of occupation:-
Proof of possession
i. Registered Document :
ii. Property Tax Receipt
iii. Electricity Bill Receipt :
iv. Water bill receipt
v. Any other proof to establish
possession (Building Construction
permission from Local Body)

(f). Area covered by Residential/ Non-Residential Structure

in Sq.Yards.
(Note: See operational guidelines for the said G.O.).
5. Particulars of Notices, if any received by the occupant from :
the Competent Authorities
6. Details of Court Litigations if any? :
7 Details of DD in token of advance payment.
8 Basic Value of the Land
9. Checklist Enclosed Y/N

DECLARATION

I………………………………………………………………. S/o. D/o./ H/o.W/o of Sri /

Smt. …………………................................................................... declare that the information furnished
above is correct. I am willing to get regularization of my possession over the land on payment of the
basic value under G.O.Ms.No. 59, Revenue (Assn.II) Dept., dt.30.12.2014.

Place: SIGNATURE:
Date: Name in Block Letters:

--------------------------------------------------------------------------------------------------------------------

Application. No:

ACKNOWLEDGEMENT FOR APPLICATION UNDER G.O.MS.NO.59 DATED: 30.12.2014.

The application of Sri / Smt ………………………………………………………………. S/o. D/o.
/ H/o. W/o of Sri / Smt …………………................................................................... is received on
_________ along with Check List and enclosures.

DATE: SIGNATURE WITH SEAL

 GOMs59

Check List for G.O.Ms.No.59 (Please Mark If Yes and x If No)

1. Application form with Signature

and photo of the applicant & his :

/her spouse

2. Proof of Identity:

1. Aadhar Card :

2. Any other document

a. Voter ID card :

b. Driving License :

c. Passport :

d. Bank Pass Book :

3. Proof of possession:

a) Registered Document :

b) Property Tax Receipt :

c) Electricity Bill Receipt :

d) Water bill receipt :

4. Any other proof to

establish possession

1. Building Construction
Permission from Local :
Body

5. DD in token of advance payment: