FORM ‘C’

Application for Deposit of Rent

Before…………………………………………………………………………Controller

Name……………………………………………………………………………Petitioner

Versus

Name……………………………………………………………………………Landlord

(1) The premises for which the rent is deposited with a description sufficient for identifying the premises.

(2) The period for which the rent is deposited and the rate per month.

(3) The name and address of the landlord or the person or persons claiming to be entitled to such rent.

(4) The reasons and circumstances for which the application for depositing the rent is made.

(5) The amount of rent deposited.

(6) Whether electricity, water charges, property tax, etc, are included in the rent, and if so, particulars thereof.

(7) How the rent was tendered to the landlord whether in person or be postal money order or cheque, etc, and whether it was refused by him in writing or otherwise.

(8) Whether there is bona fide doubt as to the person or persons to whom the rent is payable and if so, why?

(9) Date on which the rent last paid to the landlord the receipts, if any, obtained from him therefor.

(10) Any other relevant information.

The statements made above are true to the best of my knowledge and belief and I,………………..the applicant/recognised agent signed application on the………day of the month of………………in the year 19……………..

………………………………………..

Signature of the applicant/recognised agent