[See Rule 315(2)]

To, The Registrar/Deputy Registrar, Co-operative Society, U.A. ................................................. Sir, We he undersigned members of the Co-operative Farming Society........................................................ hold Bhumidhari and Sirdari right in lands details of which are given below. We have agreed to pool the said land with the Co-operative Farming Society.......................................... and we shall abide by all the relevant provisions of Co-operative Society Act, Rules and the Bye-laws etc. Serial number Name of tenure holders (applicants with parentage residence and age) Nature of tenure Khasra numbers of fields in the holding with area in acres of standard bighas show as denominator Total area of the holding Total land revenue of the holding Remarks of Applicants 1 2 3 4 5 6 7 Signature of members Your's faithfully 1........................3. .......................... 5............................ 2.......................4.............................6............................ Enclosure : A copy of the certified extracts from the record-of-rights of the most recent year.