| 1. Year of Assessment |
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| 2. Property Identification Code |
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| 3. Residential/Non-residential |
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| 4. If Residential whether |
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| (i) self occupied |
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| (ii) tenanted. |
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| 5. Name of the Owner(s) |
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| 6. Age (attach proof if 65 years or more) |
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| 7. Sex |
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8. If physically challenged, specify disability (attachcertificate)
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| 9. Name of occupier(s) |
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| 10. (a) Postal address for correspondence |
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| (b) Telephone No. |
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| (i) Residence |
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| (ii) Office Fax |
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| (iii) Fax |
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| (iv) E-Mail |
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(e) Name of Bank,Branch and Account No.
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| 11. Address of Property |
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| (a)(i) Zone |
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| (ii) Ward |
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| (iii) Circle |
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| (b) Property No. |
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| (c) Name of the floor |
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| (d) Name of Road/Street |
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(e) Stage/Phase/BlockNo.
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| (f) Locality/Colony |
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| (g) Delhi Pin Code No. |
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| 12. Details about the Property |
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1. In the case of plottedhouse/buildings
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A. Plot Area '(in sq. mtrs) |
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| B. Details of site |
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(a) Vacant land area (in sq.mtrs.)
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(b) Total covered area (in sq.mtrs.)
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| (i) Basement |
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| (ii) Ground floor |
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| (iii) Mezzanine floor |
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| (iv) First floor |
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| (v) Second floor |
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| (vi) Third floor and so on |
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| II. In the case of flats |
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| A. Type of flat |
JANTA/LIG/MIG/HIG OR ONE/TWO/THREE/FOUR BEDROOMS |
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B. Vacant land area (e.g. shaftetc.) sq. mtrs.)
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C. Covered area of the flat (insq. mtrs.)
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D. Share of common area (in sq.mtrs.)
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| 13. Year of construction |
Year covered area (in sq. mtrs.) |
| (i) Phase I |
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| (ii) Phase II |
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| (iii) Phase III |
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14. Please tick the correct category/factor and also fill thearea details (in case of properties having portions withdifferent factors, separate details for each portion may befurnished).
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| (i) Colony category (CF) |
A/B/C/D/E/F/G/H |
| (ii) Structure (SF) |
Urban village/Rural village Resettlement colony/SlumPucca/Semi Pucca/Katcha covered area (in sq. mtrs.)
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| (iii) Use of property (UF) |
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| (a) Residential |
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| (b) Non-residential |
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| (i) Public purpose |
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| (ii) Public utilities |
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| (iii) Industrial |
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| (iv) Recreational /Sports |
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(v) Business/Mercantile/Establishment /Shop
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| (vi) Office |
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| (vii) Hospital /Nursing Home |
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| (viii) Educational |
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| (ix) Star Hotel |
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| (a) upto two-star |
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| (b) three-star & above |
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| (x) Towers |
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| (xi) Hoardings |
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| (xii) Farmhouse |
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| (xiii) Others |
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| (iv) Occupancy(OF) |
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| (a) Self occupied |
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| (b) Tenanted |
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(v) Width of Road/Street on whichproperty is situated
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15. In the case of one/life-time scheme, rateable valueassessed (attach assessment order/proof)
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16. Details of property claimed to be exempted (specify clauseof section 115)
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| 17. Details of rebate claimed (Section 114 B) |
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| 18. Documents attached |
1. Certificate of covered area |
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2................................................ |
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3................................................ |
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4................................................ |