Application Form Sl.No...... Dated: ............. APPLICATION FORM Application Form for allotment of alternative plot under the scheme of Large Scale Acquisition, Development and Disposal of Land in Delhi. 1. Name................................... 2. Father's/Husband's Name........................... 3. Age.................................... 4. Present address................................ ..................................... 5. Particulars of applicant's acquired land & his share. Award No, & Date Village Khasra Nos. of acquired land 1. 2 3 A ......... ......... .................. B .......... ......... ................... C .......... ......... .. . .................. Total land Applicant's share Amount of compensation Date received __________________________________________________________________________________ 4 5 6 7 __________________________________________________________________________________ A ...... ....... ......... ............ B ...... ......... .......... ............ C ....... ....... ......... ............. 6. Whether any stay/court cases pending against this acquisition. If yes give details 7. If the acquired land is not ancestral, then A. Date of purchase B. Mutation order No.& Date 8. Particulars of House/plot/flat owned by the applicant and/or his wife/husband and dependent relation (includ ing unmarried children) in urbanised areas of Delhi, New Delhi and Delhi Cantt except in village abadi. 9. Whether any land owned by the applicant, his wife / husband & dependent relations (including the unmarried children ) in Delhi, New Delhi and Delhi Cantt has been Acquired ? If yes, its particulars. 10. If the recorded owner at the time of Notification u/s 4 has died, then (i) Name of legal heirs, their age and relation with recorded owner: Yes/ No .......... .......... ......... ......... House/plot/flat No. ...... Address......... Area ............. Yes/No............ If yes then give particulars... ........... Village............ Award No. & Date...... Khasra No......... Name Age Relationship (ii) Particulars of House/plot/flat owned by each of the above in urbanised area of Delhi, New Delhi or Delhi Cantt, except in village abadi. House/plot/flat No...... Address ..................... ............ Area ........... 11. (A) Is the applicant, his wife/husband and dependent relations (including unmarried children) member of any co-operative House Building/ co-operative Group Housing society? If Yes, give details:- Name & Address .............. .............. ............... (B). Has the land been allotted to the society? If yes, then give details :- Locality.............Total Area........... 12. Whether the applicant has applied earlier for allotment of alternative plot in lieu of this or any other acquired land ? Yes/NoIf yes, thenDate............. Applicaton form No./ File No.............. Decision taken......... Date..... Signature of the applicant 13. Verification by Land Acquisition Collector. (A) Whether the details given in Col.No.1,2,5 and 6 are correct? Correct/If not, then give details ............. (B) Details regarding Ancestral land (i) Number and date of Notification u/s 4 of the Land No................ Acquisition Act. Date................ (ii) Name of recorded owner at the time of Notifi cation u/s 4 of the Land Acquisition Act. ................... (C). If the compensation of the acquired land has not been paid to the recorded owner shown in Col.13 (ii) above, then the names of his legal heirs, amount .................. and share of compensation paid to each of them. .................. (D).whether the possession of the acquired land has been taken over wholly. If yes, then give date/if not, give details. (E). Details regarding self-acquired land Yes/No Whether this land has been mutated in favour of No................ the applicant ? If yes then No. and date Date................. Signature of LAC with stamp. CONDITIONS OF ELIGIBILITY 1. A). In ancestral land, the ownership of acquired land should be at the time of notification u/s 4 of Land Acquisition Act. B). The purchase of land should be prior to notification u/s 4 of Land Acquisition Act and should Not be in violation of Delhi Land Reforms Act, 1954. the Delhi land (Restriction on Transfer) Act, 1972 or any other law in force. 2. The compensation should have been received from LAC/Addl.Distt. Judge. 3. The applicant/ recorded owner/his wife/husband and dependent relations (including unmarried Children) should not own any house/plot/flat in the urbanised area of Delhi, New Delhi and Delhi Cantt. and neither should they be members of any cooperative House Building/ Cooperative Group Housing Society. FORM OF AFFIDAVIT TO BE SUBMITTED WITH APPLICATION FORM (Should be filled on non-Judicial stamp paper of Rs.10/-) AFFIDAVIT I, --------- son of ------------, resident of -----------, do here by solemnly affirm and declare as under: 1. That my land measuring ---------bighas situated in Village ----------, New Delhi was acquired by the L.A.C. vide Award No. ------/------dated --------and the compensation of the same has been paid to m e on ----------. 2. That there is no built up out of the above acquired land and the possession of the entire acquired land stated above has been taken over by the L.A.C. on----. 3. That I am claiming alternative plot against the land so acquired by the L.A.C. of which the undersigned is recorded owner before the notification issued u/s 4 of the L.A.Act. I will not claim any alternative plot in future in case my remaining land detailed below is acquired. (The details of the remaining unacquired land are to be given) : No. 4. That no land in my name was earlier acquired by the L.A.C. (if any land belongs to the applicant, was earlier acquired, details of the same are to be given. Also state whether application for alternative plot was made by the applicant or by any of his family members against the acquired land earlier and if so what is the status of that application). 5. That I shall be fully responsible for making false statement in the affidavit and application form and shall be responsible for all the consequences which may arise and also bear all the losses including litigation expenses incurred by the Govt. 6. That I have neither applied before nor shall apply in future for the alternative plot in r/o land in question or any other land. None of my other family members have been allotted or applied for alternative plot in lieu of this land. 7. That I have not relinquished my share in favour of any member of my family earlier against this land or any other land owned by me. 8. That I including my dependent relations and unmarried children do not have any plot/flat.house in the state of Delhi except in village abadi (name of village to be mentioned). 9. That I including my dependent relations and unmarried children do not have membership in any group housing society in the State of Delhi. 10. That there is no court case pending against the acquisition of the land. 11. That the information and documents furnished with the application form are correct and genuine to the best of my knowledge and belief and no material information has been concealed therefrom. Deponent Verification: Verified at New Delhi on this----------------------day that the contents of the above affidavit are true and correct to the best of my knowledge and belief, and nothing has been concealed therefrom. Deponent Date: Place:
