Schedule

Declaration under Section 6(1) I.....................(aged............................................year..........................................) residing at ...................being desirous of availing myself of financial assistance from Agricultural Credit Operations and Miscellaneous Provisions (Banks) Act, 1977 and I hereby create a charge on the said land/interest in land in favour of the bank for securing the financial assistance which the bank may make and for all future assistance, if any, which the bank may make to me together with interest and costs and expenses thereon. Name of Name of C.D. Name of Survey No. Boundaries Area village Block and Sub- Division District Plot No. City South East North West Acres kathas 1 2 3 4 5 Assessment Appropriate Encumbrances, if Remarks, if Value any any Rs. P. Nature Amount 7 8 9 In witness whereof, I ......... hereunder set my hand this day of .......the year..................and........... Witness............signed and delivered by the abovenamed in the presence of (1) (2) Attested by Signature of declarant Forwarded with compliments to the Anchal Adhikari/Revenue Officer with a request to include the particulars of the charge....created under the declaration in the record-of-rights and/or other appropriate registers and to return to the bank for its record. Manager/ Agent ............Bank Place.............. Returned with compliments to the manager/Agent Bank the charge created/under the declaration is duly included in the record-of-rights and/ or register on the day of...........................19..... Anchaladhikari 11/11 Revenue Officer Forwarded with compliments to the Sub-Registrar with a request to record the particulars of the charge created under the declaration in his office. Manager/ Agent ............Bank Place.............. Returned with compliments to the Manager/Agent Bank the charge created under the declaration is duly recorded. Date............. Sub-Registrar