It is mandatory for all house owners wishing to rent out their property to furnish this information u/s 144 Cr.P.C. by order of district Magistrate of concerned area and withholding the same is an offence u/s 188 Cr.P.C.
Fill the following proforma form and enclose the photocopy of rent deed (if any) submit/sent the same to the concerned Police Station along with the copy of same to the Gujrat, Commissioner of Police through Speed Post or by Hand and get the proper acknowledgment for the same
LANDLOARD/TENANT INFORMATION
( Filled the same in capital letters only)
1. Landlord/Owner Information
House No. ___________________________________Sector/Village ___________________________
Name of Owner________________________________Since________ ___Phone No.______________
Father/Husband Name______________________________________________ ___________________
Permanent Address___________________________________________ ________________________
________________________________________ Distt. ___________________State_______________
Police Station ______________________Phone No. _____________Occupation__________________
Whether landlord residing in the House Yes/No
If yes, furnish the following information.
(A) PARTICULARS OF FAMILY MEMBERS RESIDING WITH THE OWNER
Sr.
No.
Name Age Sex Relation Occupation Voter I-Card No.
1.
2.
3.
4.
5.
6.
7.
8.
(B) PARTICULARS OF VEHICLES OWNED BY LANDLOARD OR HIS/HER
FAMILY MEMBERS
Sr.
No.
Registration No. Registered owner Type Make Model
1.
2.
3.
4.
5.
(C) WEPON DETAILS
Sr.
No.
Type/Make of
Weapon
Bore Valid Up to License
No,
Name of License
Holder
Issue
authority
1.
2.
3.
(D) PASSPORT DETAIL
Sr.
No.
Passport No. Name of Passport
Holder
Date of Issue Issuing
Authority
Nationality
1.
2.
3.
Having any servant or not ________________________________(if yes, fill up Servant information
form also)
Having tenants _________________________________(if yes, fill up Tenant information form also)
Certified that the information given above is correct to my knowledge and belief and nothing has been
concealed therein.
Name_______________________________Signature______ ________________Date_____________
FOR KIND ATTENTION OF THE RESIDENTS OF CITY............../STATE of Gujrat
This form can be used by the Gujrat Police to collect information from the residents of
Gujrat to help/check crimes and it is mandatory to furnish this information u/s 144 Cr.P.C. by
order of district Magistrate of concerned area and withholding the same is an offence u/s 188 Cr.P.C.
__________________________________________________ ________________________________
FOR USE OF POLICE STATION
Received on ___________________________________________
PS Dairy No. __________________________________________
Authorized Signatory
Name _______________________________________________
Rank ________________________________________________
No. _________________________________________________
STATEMENT REGARDING TENANTS, FLOOR -1
Address_________________________________ Tenants Name______________________
S/o, D/o, W/o ____________________________ Tenants since_______________________
Occupation_______________________________ Tel. No.___________________________
Vehicle No.______________________________ Licensed Weapon (detail)_____________
Originally from (permanent address), R/o Vill.__________________________________________
Police Station_____________________________Distt.________ ________State_______________
Both husband wife serving Yes/No. Husband Wife
Place of work______________________________________________ _______________________
Time of day/Night house in unoccupied________________________________________ __
PRTICULARS OF MAIL FAMILY MEMBER’S
Sr.
No.
Name Age Sex Relation Occupation
STATEMENT REGARDING TENANTS, FLOOR -2
Address_________________________________ Tenants Name______________________
S/o, D/o, W/o ____________________________ Tenants since_______________________
Occupation_______________________________ Tel. No.___________________________
Vehicle No.______________________________ Licensed Weapon (detail)_____________
Originally from (permanent address), R/o Vill.__________________________________________
Police Station_____________________________Distt.________ ________State_______________
Both husband wife serving Yes/No. Husband Wife
Place of work______________________________________________ _______________________
Time of day/Night house in unoccupied________________________________________ __
PRTICULARS OF MAIL FAMILY MEMBER’S
Sr.
No.
Name Age Sex Relation Occupation
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