Barnia SKUS Ltd. | Samabay Krishi Unnayan Samiti

Membership No *

Full Name *

Father/Husband Name *

Date of Birth

Mobile Number *

Occupation *

Annual Income (₹) *

Educational Qualification *

Caste *

Religion *

Village / Street *

Post Office *

Police Station *

District *

State *

Pin Code *

Mouza	Khatian No	Dag No	Area (Dec)	Classification	Action

Applicant Photo *

Signature *

I am a member of the Society and the details furnished above are true.
I am the owner/cultivator of the land details provided herein.
I authorize the Society to verify the land records and other documents submitted.

I confirm that the details provided above are true and correct.

Barnia Samabay Krishi Unnayan Samiti Ltd.