Farmer Area Sown Certificate Entry & Print

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FARMER AREA SOWN CERTIFICATE

(Self Declaration Form)

1. FARMER DETAILS

NAME OF ENROLLED FARMER:

S/O:

ADDRESS:

FARMER CATEGORY: LAND OWNER TENANT FARMER SHARE CROPPER (PLEASE TICK ONE)

NAME OF THE LAND OWNER FARMER (IF APPLICABLE):

CONTACT DETAILS (MOBILE NO.):

AGE:

SEX: MALE FEMALE

2. BANKING / KCC INFORMATION

WHETHER THE APPLICANT HAS KCC: YES NO

3. DETAILS OF LAND UNDER CULTIVATION (INTENDED FOR CULTIVATION)

DISTRICT:

YEAR:

SEASON:

SI.	CROP	DISTRICT	BLOCK	GP	MOUZA WITH J.L. NO.	PLOT NO.	AREA OF CROP (HA)	REMARKS

DECLARATION:
I HEREBY CERTIFY THAT THE INFORMATION FURNISHED ABOVE REGARDING THE SOWN AREA IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. IN CASE ANY PART OF THE STATEMENT IS FOUND TO BE FALSE OR INCORRECT AT ANY STAGE, MY CLAIM/APPLICATION SHALL BE LIABLE TO BE REJECTED.