(To be printed on the Letter Head of the Headman/Sordar/Nokma council)

ANNEXURE I – COMMUNITY LAND

FORMAT OF CERTIFICATE FOR AVAILING FARMER’S IDENTITY CARD

(DOCUMENTARY PROOF)

AGRICULTURE LAND USE DECLARATION

This is to certify that Shri/Smt _______________________________________ a resident of

Village ____________________ under ___________________________ CD Block
___________________________ District ____________________ , is a bonafide farmer who is
cultivating on community land of approximate ___________________________ (Acre) for
agriculture purpose only.

Designated Signatories

Signature & seal of Headman / Nokma /

Doloi / Wahdadar

Countersigned by:-
(Name, Signature & seal)
DAO / ADO / HDO
(Block / Circle)

*This certified copy is specifically meant for availing benefits from Government
 (To be printed on the Letter Head of the Headman/Sordar/Nokma council)

ANNEXURE II - CLAN LAND

FORMAT OF CERTIFICATE FOR AVAILING FARMER’S IDENTITY CARD

(DOCUMENTARY PROOF)

AGRICULTURE LAND USE DECLARATION

This is to certify that Shri/Smt _______________________________________ a resident of

Village ____________________ under ___________________________ CD Block
___________________________ District ____________________ , is a bonafide farmer who is
cultivating on clan land of approximate ___________________________ (Acre) for agriculture
purpose only.

Designated Signatories
Certified from head of the clan
(Signature & Seal)

Validated by: (Name, Signature & seal)

of Headman / Nokma / Doloi / Wahdadar

Countersigned by:-
(Name, Signature & seal)
DAO / ADO / HDO
(Block / Circle)

*This certified copy is specifically meant for availing benefits from Government
 (To be printed on the Letter Head of the Headman/Sordar/Nokma council)

ANNEXURE III – LEASED LAND

FORMAT OF CERTIFICATE FOR AVAILING FARMER’S IDENTITY CARD

(DOCUMENTARY PROOF)

AGRICULTURE LAND USE DECLARATION

This is to certify that Shri/Smt _______________________________________ a resident of

Village ____________________ under ___________________________ CD Block
___________________________ District ____________________ , is a bonafide farmer who is
cultivating on community land of approximate ___________________________ (Acre) for
agriculture purpose only.

Designated Signatories
Validated by: (Name, Signature & seal)
of Headman / Nokma / Doloi / Wahdadar
Certified from Land owner

Countersigned by:-
(Signature & seal)
DAO / ADO / HDO
(Block / Circle)

*This certified copy is specifically meant for availing benefits from Government

(To be printed on the Letter Head of the Headman/Sordar/Nokma council)

 ANNEXURE IV – FOREST LAND

FORMAT OF CERTIFICATE FOR AVAILING FARMER’S IDENTITY CARD

(DOCUMENTARY PROOF)

AGRICULTURE LAND USE DECLARATION

This is to certify that Shri/Smt _______________________________________ a resident of
Village ____________________ under ___________________________ CD Block
___________________________ District ____________________ , is a bonafide farmer who is
cultivating on Forest land of approximate ___________________________ (Acre) for agriculture
purpose.

Validated by: (Name, Signature & seal) No objection Certificate (NOC )

of Headman / Nokma / Doloi / Wahdadar from Forest Department (enclosed)

Verified by:-
(Name, Signature & seal)
DAO / ADO / HDO

*This certified copy is specifically meant for availing benefits from Government

(To be printed on the Letter Head of the Headman/Sordar/Nokma council)

 ANNEXURE V – OWN LAND

FORMAT OF CERTIFICATE FOR AVAILING FARMER’S IDENTITY CARD

(DOCUMENTARY PROOF)

AGRICULTURE LAND USE DECLARATION

This is to certify that Shri/Smt _______________________________________ a resident of

Village ____________________ under ___________________________ CD Block
___________________________ District ____________________ , is a bonafide farmer who is
cultivating on Own land of approximate ___________________________ (Acre) for agriculture
purpose only.

(A) Any one of the enclosures to be submitted

(if available)
1. Document from Revenue Branch
2. Document from District Council
3. Document from Syiem ship / Sordar ship /
Confederacy / Nokman / Doloi ship / Elaka.

(B) Document from Rangbah Shnong / Doloi /

Nokma / Sordar / Wahdadar ( if the above
documents at (A) are not available )

Verified by:-
(Signature & seal)
DAO / ADO / HDO
(Block / Circle)

*This certified copy is specifically meant for availing benefits from Government