CHENNAI POLICE

FORMAT FOR INFORMATION ON TENANTS

1. Name of the Landlord
:
2. Occupation Details
:
(Office Address & Phone No.)
3. Residence Address
(With Phone No.)

___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________

PARTICULARS OF TENANT TO WHOM PREMISES LET OUT

1. Name, Age
(With Mobile Phone No.)
Fathers Name
2. Permanent Address
(With Phone No.)

:
:
:

3. Occupation Details
:
(Office Address & Phone No.)
4. Present Address
:
(Premises occupied now on rent)
5. Details of the Co-occupants :
S. No.
1
2
3
4
5

___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
PHOTO OF
___________________________________________________
TENANT
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________

Name

6. Previous Residence Address:

Age

Relationship

___________________________________________________

(With Phone No. & Date of Vacation)__________________________________________________

___________________________________________________
7. Details of the anyone of the following ID Proof : _______________________________________
(Passport, Driving License, Arms License, Ration Card, Voter ID, Pan Card) ___________________
This is to certify that the information furnished above are true.

Signature of the Landlord

Signature of the Tenant

(With Date)

(With Date)

Received the Copy

Signature of the SHO with PS Seal
(A Copy to be handed over to the Landlord)

CHENNAI POLICE
FORMAT FOR INFORMATION ON TENANTS
1. Name of Landlord ...........................................................................................................

2. Occupation Details ........................... . .... . .............................. . .......................................

. . .

(Office Address with Phone No)

3. Residence Address ......................................................................................................... .

(with Phone No.)

Particulars of tenant to whom premises let out

..-------..

1. Name, Age ..........................................................................................

(with Mobile Phone No.) ............................................................................... .

Father's Name .....................................................................................

PHOTO
OF
TENANT

2. Permanent Address............................................................................ . .
(with Phone No.)

3. Occupation Details............................................................................................................
(Office Address with Phone No.)
4. Present Address ...............................................................................................................
(Premises occupied now on rent)

5. Details of the Co-occupants:

SI.No.

Relationship

Name

6. Previous Residence Address........................................................................................... .

(with Phone No. & Date of vacation)
o o 0 o 0 I o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o I I o o o o o o o o o o o o o o o o o o o o o o o o o o o o 0 o o o o o o o o o o o o o o o o o o o o o o I I o o o o o o o o o o o o o o o o o o o o o I I I I

7. Details of any one of the following ID Proof:-

Passport, Driving License,

Arms License, Ration Card, Voter ID, Pan Card ..........................................................

This is to certify that the information furnished above are true.

Signature of Tenant

Signature of Landlord

(with date)

(with date)

Received the copy

Signature of the SHO with PS Seal
(A copy to be handed over to the landlord)