Application for recovery of arrears of rent under section 12(2)

To The Mamlatdar of ............ Name of the applicant ......... Age ........ Profession ...........Place of residence...... Name of the opponent........ Age ......... Profession ........ place of residence ........ Sir, I do hereby state that I am the landlord and the opponent is my tenant in respect of the following lands. Taluka | Village | Survey description | Assessment. The opponent is in arrears of the rent from the following years. Year | Rent payable | Rent actually received so far | Rent in arrears. The total rent in arrears with the opponent for the above years is ... I request you to direct the opponent that above said arrears of rent together with the cost of the proceedings should be paid to me within the stipulated time under section 12 of the Goa, Daman and Diu Agricultural Tenancy Act, 1964. I enclose the following documents. (Here give a list of documents ) 1... 2... 3... 4... The following are my witnesses, They may be summoned / will be produced to attend on the day of the hearing. Place... Date... Place… Yours faithfully, Signature of applicant