Name _________________________________________ .Petitioner
.Vs
Name _________________________________________
.Landlord
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1. Premises for which the rent is to be deposited with a description sufficient to identify the premises. |
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2. Period for which the rent is to be deposited and the rate per month. |
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3. The name & address of the landlord or the person or persons claiming to be entitled to such rent. |
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4.The reasons and circumstances due to which the application for depositing the rent has been made. |
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5. The amount of the rent to be deposited. |
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6.Whether electricity, water charges, property tax etc. are included in the Rent, if so particulars thereof. |
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7. How the rent was
tendered to the landlord, whether in
person or by postal money order or by
cheque etc. and whether it was refused
by him in writing or
otherwise. |
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8.Whether there is a bonafide doubt as the person or persons to whom the rent is payable and if so, why? |
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9. Date on which the rent was last paid to the landlord and the receipt, if any, obtained from him thereof. |
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10. Any other relevant information. |
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The statements made above
are true to the best of my knowledge and belief and the applicant/recognised agent
has signed the application on the
.. day of
20
at Delhi.
Signature of applicant/recognised agent