APPLICATION FORM FOR CERTIFIED COPY OF SURVEY COMPUTERISED PLAN 1) Name of the Applicant : 2) Residential Address : i) House No. ______________ ii) Ward ________________ iii) Village _______________ iv) Taluka _______________ v) District South Goa. Details of Property : 1) Village ______________________________________ 2) Taluka _______________________________________ 3) Survey No./Sub-Div.No. ________________________ Signature of the Applicant _______________________ For Office use CITY SURVEY _______________________ APPLICATION - FORM FOR CERTIFIED COPY OF SURVEY PLAN/FORM 'B' 1. Name of the Applicant : 2. Address : Ward House No. Village/City : Taluka ____________________________ Goa. DETAILS OF PROPERTY 1. City : 2. Taluka : 3. P. T. Sheet No./Chalta No. : Date : Signature of the Applicant. For Office use :