Form A

[Rule 4]

Report of unauthorised occupation of land which is poramboke/the Property of Government other than poramboke in the Village of..............in the Taluk of

1. Survey number of poramboke or the Survey number of property of Government other than poramboke with the whole extent.
2. Description of the land, whether unassessed or poramboke, if poramboke, its nature.
3. Extent of encroachment.
4. Name and address of the occupant, state whether he is poor, an ex-service man, a Harijan etc.
5. No. of holding and the total of wet and dry lands owned by the occupant.
6. How occupied by cultivation or erection of houses etc. If there are trees, their description.
7. Period of occupation.
8. Prohibitory assessment, if any, previously imposed.
9. Village Officer's remarks with the signature and date.
10. Revenue Supervisor's or Revenue Inspector's remarks.
11. Tahsildar's opinion on inspection.
12. Plotted sketch drawn to scale of the encroachment.
13. Detailed Mahazar.

(Note:- Items 12 and 13 may be prepared separately).