Schedule -5
(Related to Sub-rule (3) of Rule 13 and Sub-rule (1) of Rule 18)
Application to be Submitted for the Registration of Consumer
Committee / Groups
Date :-
The Chairperson,
Office of Kanchanjungha Conservation
Area Council.
We have submitted this application mentioning the following details  and requesting to register this consumer group / committee after constituting a consumer group / committee as pursuant to the Kanchanjungha Conservation
Area Rules, 2064.
1. Name of the Consumer Group / Committee :
2. Boundaries :
East :
West :
North :
South :
3. Estimated Area :
4. No. of Consumers / Consumer Groups :
5. Number of Household :
6. Total Population :
7. Details of the officials and members of the consumer group / committee:
48
S.N. Name Address Father/Mother’s
Name
Grandfather/
mother’s Name
Address Signature Designation
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Person Submitting application on behalf
of the Consumer Group ⁄ Committee:
Signature :
Name and Surname :
Address :
Designation :
Date :