Name*

Name of Land/Property Owner*

Mobile Number*

Landline*

Address Line 1:*

Address Line 2:*

Address Line 3:*

Email:*

Property Address:*

Landmarks:*

Property Area/Location:*

Property Extent(in grounds - acres/hectares)*

North:*

West:*

East:*

South:*

Frontage (In feet):*

Road Width (In feet):*