Form CC *
[Rule I3A]
To
……………………….
Whereas you are found to be in unauthorised occupation of the land described in the Schedule below which is a poramboke /property of Government other than poramboke and whereas I am satisfied that in the public interest, to wit...................... (here explain the reason) it is expedient to take urgent action for the removal of such occupation, you are hereby required to vacate the land within ...............days from the date of receipt of this notice, failing which you will be summarily evicted from the land by, using force, if necessary and any crop or other product raised on the land, any building or other construction created or anything deposited thereon shall be liable to forfeiture.
| Village | Sy. No. and sub-division No. | Description of land | Entire extent | Occupied extent | Nature of occupation |
| (1) | (2) | (3) | (4) | (5) | (6) |
Amount of fine :
Amount of assessment :
Period for which arrears for assessment is charged :
Amount of arrears :
Total amount due :
Take notice also that the Village Officer/Deputy Tahsildar………is hereby authorised to carryout the eviction and to take possession of, and retain in proper custody anything in the land which is liable to forfeiture pending my order as to its disposal.
Collector
Place:
Date:
[(Seal)]
* Inserted by SRO 1403/89 dt. 28-06-1989 pub. in K.G. No. 32 dt 08-08-1989.