Schedule

Declaration under section 6(1) I,.....................(aged...............years) residing at ......................... .......... ...............being desirous of availing myself of financial assistance from the....................... ......................bank make this declaration as required by section 6(1) of the Himachal Pradesh Agricultural Credit Operations and Miscellaneous Provisions (Banks) Act, 1972, that I...........................own/ have interest as tenant in the land specified below, 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, costs and expenses thereon. ______________________________________________________________ Name of Revenue Name of Name of Khasra Boundaries Area in Estate Tehsil District number South, North, acres East, West 1 2 3 4 5 6 Assessment Encumbrances, if any Remarks, if any --------------- Approximate ------------------------------Rupees Paise value Nature Amount 7 8 9 10 11 In witness whereof, I, Shri.......................Hereunder set my hand this........................day of.....................in the year one thousand nine hundred and......................................................... Witnesses. Signed and delivered by the above named in the presence of:- (1) (2) Signature of declarant. ATTESTED BY Forwarded with compliments to the Tehsildar with a request to include the particulars of the charge.......................created under the declaration in the record-of-rights 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-ofrights on the .....................day of.......................19 Tehsildar. 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. -------------- Sub-Registrar.