GOVERNMENT OF GOA DIRECTORATE OF SETTLEMENT & LAND RECORDS, PANAJI GOA. OFFICE OF THE INSPECTOR OF SURVEY & LAND RECORDS CITY SURVEY _______________________ APPLICATION FORM FOR CERTIFIED COPY OF SURVEY PLAN/FORM 'B' 1) Name of the Applicant : 2) Residential Address : I) House No. : ________________________ ii) Ward : ________________________ iii) Village : ________________________ iv) District : ________________________ v) Taluka : ________________________ Details of Property 3) Village : ______________________________ 4) Taluka : ______________________________ 5) Survey No./SubDiv.No : ______________________________ Signature of the Applicant Date : Place : For Office use
