PUDUCHERRY POLICE FORMAT FOR INFORMATION OF TENANTS 1. Name of Landlord __________________________________________________ Occupation with Details of Office, phone no. _______________________________________________ 2. Address _____________________________________________________________ Phone No. ___________________________________________________________ Particulars of tenant to whom premises let out 1. Name __________________________Father's Name _________________________ 2. Occupation with details of office phone number ______________________________ 3. Age ___________Family Members: Name Age Relationship 4. Present Address __________________________________________________________ 5. Previous residence address _________________________________________________ and telephone no. date of leaving _________________________________________________ 6. Permanent address and telephone number _________________________________________________ 7. Details of either any one of the following Passport, Driving License, Arms License, Ration Card, Voter Card, Income Tax (Pan No.) _______________________________________________ Signature of landlord PHOTO OF TENANT 2 ACKNOWLEDGEMENT Received from Shri / Smt. ______________________S/o _________________________ R/o ______________________________________________Ph. No.________________ Intimation of letting out _________________________to Shri _____________________ S/o _______________________________ Date Diary No. Signature of Recipient _______________________ Name & Designation ________________________ Police Station __________________Seal:
