Date:
To,
The Senior Inspector / In-Charge,
Police Station,
, Maharashtra.
Subject: Intimation of New Tenant / Licensee at Residential Premises —
Respected Sir / Madam,
I, the undersigned, hereby submit this intimation informing your office that I have given my residential premises on Leave and License / Rent to the tenant / licensee named below, with effect from . The details are as follows:
| Full Name | |
|---|---|
| Address (Permanent) | |
| Mobile Number | |
| Aadhaar No. |
| Flat / Unit No., Floor, Wing | |
|---|---|
| Building / Society Name | |
| Road / Street / Area | |
| City, Pincode |
| Full Name | |
|---|---|
| Father's / Husband's Name | |
| Date of Birth | |
| Occupation / Employer | |
| Aadhaar No. | |
| Voter ID / PAN / Passport | |
| Mobile Number | |
| Permanent / Native Address | |
| District / State of Origin | |
| No. of Family Members / Co-occupants | persons — Names: |
| Vehicle Details (if any) | Type: No.: |
| Date of Agreement | |
|---|---|
| Possession Date (Move-in) | |
| Agreement Duration | months (from to ) |
| Monthly Rent (License Fee) | Rs. |
DECLARATION BY LANDLORD:
I hereby declare that all the information furnished above is true, complete, and correct to the best of my knowledge and belief. I understand that furnishing false information is an offence. I request your office to kindly take note of the above and carry out verification / conduct any enquiry as deemed necessary.
ENCLOSURES:
| Received by (Name / Designation) | |
|---|---|
| Date & Time of Receipt | |
| Reference / Diary No. | |
| Verification Status | ☐ Clear ☐ Under Verification ☐ Suspicious — Report Filed |
| Remarks |
— End of Police Intimation Letter —
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