ULHASNAGAR MUNICIPAL CORPORATION CITIZEN FACILITATION CENTRE SUBJECT: TRANSFER OF LICENSE BY SELLING / PARTNERSHIP DEED / OTHER THAN NOMINATION Token Number (For Office Use) Date:- / / (If Citizen Identification Number is given, do not fill below Details) Applicant's Details: Last Name/ Surname Name Father/Husband's Name Details of Society (If Application from Society): Name Of Society: Designation Address: Head Information House/Building/Soc. Name: Flat/Block/Barrack No.: Wing/Floor: Road/Street/Lane: Area/Locality/Town/City: Taluka: Pin code: Ward Committee No.: 1 [ ] 2 [ ] 3 [ ] 4 [ ] Electrol Panel No.: Telephone No. (if any): Contact Person: Email Address (if any): Information of Property: Head Information Type of Property (Please Tick [?] as applicable) [ ] Land [ ] Building Property Number (Computerized) Necessary Particulars about above service: Head Particulars 1 License Number 2 Name of the License Holder 3 Name of the Business Citizen Identification Number 4 Address of the Business Pin 5 Details of Business 6 Name, age and address of the person to whom the license is to be transfered. Name of the Transferee Surname Name Father/Husband's Name Age Sex Address of the Transferee 1 Pin 2 Pin 3 Pin 4 Pin (Note: In case the numbers of nominees are more than 4, then mentioned it on seperate page.) Necessary Enclosures related to above application are enclosed as under. (If enclosed tick [ ? ] or not enclosed tick [?] ) Enclosures Yes/No 1 Permission Letter of License holder (on stamp paper of Rs.20/-) [ ] 2 No objection certificate from Owner on Rs.20/- Stamp Paper, if the applicant is tenant [ ] Declaration I/We ................................................................................................... state on solemn affirmation that the above information is true and correct to the best of my/our knowledge. If the information given is found wrong then I/We shall be held legally liable for its consequences. Date:- Applicant's Signature ( ) The document may please be deliverd to: 1. Self/Nominated Person [ ] a) C.F.C. [ ] b) Camp No. [ ] Name of Nominated Person (________________________________________________) 2. By Post a) U.P.C. [ ] b) Register A.D. [ ] 3. Courier [ ] (Not to be filled if address is same as above) Correspondence Address:- Last Name/ Surname Name Father/Husband Name House/Building/Soc. Name: Flat/Block/Barrack No.: Wing/Floor: Road/Street/Lane: Area/Locality/Town/City: Taluka: Pin code: Email Address (if any):
