SCHEDULE

Declaration under sub-section (1) of section 5 I, .............................................................. (aged ......................... years) residing at ........................................ being desirous of availing myself of financial assistance from the .............................................. Bank, ........................................... make this declaration as required by section 5 (1) of the Maharashtra Provision of Facilities for Agricultural Credit by Banks Act, 1974, that I, .............................................. own the land/have interest as a tenant in the land, in the area specified below, and I hereby create a charge on the said land/interest in the said land, in favour of the bank for securing the financial assistance which the bank may give and for all future assistance, if any, which the bank may give to me together with interest and costs and expenses thereon. Name of Village Name of Taluka Name of District Survey No./ City Survey No. Boundaries Areas Plot No. Pot Hissa No. South-East North-West Hectares Assessment Approximate value Encumbrances, if any Remarks, if any Rupees Paise Nature When created Amount In witness whereof, I, Shri ......................................................................... hereunder set my hand this .................................... day of ............................................ in the year one thousand nine hundred and .................................... Witness Signed and delivered by the abovenamed in the presence of— (1) (2) Attested by Signature of the declarant. Forwarded with compliments to the Talathi or other designated revenue officer 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. Date .................................... Place .................................... Returned with compliments to the Manager/Agent ......................................... Bank. The charge created under the declaration is duly included in the Record of Rights on the .................................... day of .................................... 19 ............. Date.................................... Talathi or other designated 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. Date .................................... Place .................................... Returned with compliments to the Manager/Agent ......................................... Bank. The charge created under the declaration is duly recorded. Date .................................... Sub-Registrar.