DECLARATION FOR CONVERSION I/We, Shri/Smt./M/s. ....................................................................................................................................... S/o., D/o., W/o. ..............................................................................................................................Residing at ......................................................................................................................................................... do hereby solemnly affirm and declare as follows : 1. That I / We have purchased / acquired the land having the following schedule : Mouza J.L.No Khatian No. (R.S.&.L.R.) Plot no. (R.S.&.L.R.) Recorded classification Area purchased acquired P.S. Dist. 1 2 3 4 5 6 7 8 from Shri / Smt, ................................................................................................................................................ S/O., D/O., W/O., .....................................................................................................................vide registered Deed No............................................................................................. dated......................................../ through Inheritance for ......................................................................................................................................purpose, on being fully satisfied that the aforesaid transferors had good and transferable title and possession over that land in question. 2. I / We further undertake to the effect that in case the mutation is allowed, I/We will have no claim over the said land if in future the land(s) vests in the State in any proceeding under any provision of law. 3. I / we also undertake to the effect that if the land in question is found to be vested, I/We will apply to the State Government for Long Term Settlement of the same under usual terms and conditions on payment of Rent and Selami etc. as will be determined by the State Government. 4. That in case of my failure to apply for Long Term Settlement within the period of one month, I shall be liable to be evicted from the land as a trespasser and shall also be liable to payment of damage for use and occupation of the said land. 5. That I have taken over possession of the land and the said land is free from encumbrances. 6. That I have submitted chain of successive deeds as proof of title/I declare that I have purchased land from vendor being fully satisfied that the letter had good and transferable title over the land. 7. That the statements made above are true to the best of my knowledge and belief. Signature Date : ................................ Downloaded from www.barrackpore.gov.in, the official website of Barrackpore Sub-Division
