GOVERNMENT OF GOA
DIRECTORATE OF SETTLEMENT & LAND RECORDS,
PANAJI - GOA
OFFICE OF THE INSPECTOR OF SURVEY & LAND RECORDS
CITY SURVEY _______________________
APPLICATION - FORM FOR CERTIFIED COPY OF SURVEY PLAN/FORM 'B'
1) Name of the Applicant :
2) Residential Address : I) House No. : ________________________
ii) Ward : ________________________
iii) Village : ________________________
iv) District : ________________________
v) Taluka : ________________________
Details of Property
3) Village : ______________________________
4) Taluka : ______________________________
5) Survey No./Sub-Div.No : ______________________________
Signature of the Applicant
Date :
Place :
For Office use