FORM NO. II
PART – I
1. We, (1) ______________________, (2) ______________________ AND (3) ___________________, all of __________, Indian inhabitants, do jointly and severally solemnly affirm and declare as under:—
(i) That we are the Owners of the agricultural land at Village _________, Taluka _________________, District ________________, bearing Survey No.___________, Hissa No.___________ admeasuring ______________ or thereabouts which is more particularly described in the Schedule hereunder written (hereinafter “the said Agricultural land”) and which said Agricultural Land we have conveyed in favour of (1)____________________________ and (2)_____________________ by a Deed of Conveyance dated __________ 200__.
(ii) The said Agricultural Land comes in agricultural zone/Green Zone/no development zone as per the sanctioned development plan by/of __________________________ which is considered as master plan as defined under Section 2(h) of the Urban Land (Ceiling and Regulation) Act, 1976 for the area in question.
A certificate showing the zone of the said Agricultural land from the concerned Municipal Corporation/the Collector is annexed hereto as Annexure 1.
(iii) The said Agricultural land is under agricultural use since last several years till today. In support of which, extracts of V.F. VII-XII are attached herewith.
(iv) The said Agricultural land has not been put to any
non-agricultural use or to such a use which is not in confirmity with the said zone.
(v) We have filed statement as prescribed under Section 6(1) of the Urban Land (Ceiling & Regulation) Act, with the Competent Authority _________________ and it has been given file number as ________________________. The statement is yet to be decided/has been decided with the result as follows:—
2. That the total lands held by us either individually or jointly as the owners or tenants or partly as owners or partly as tenants are within Ceiling limit as provided under Bombay Agricultural Lands (Ceiling) Act/Maharashtra Agricultural Lands (Ceiling on Holdings) Act, 1961 and Bombay Tenancy & Agricultural Lands Act, 1948 and we do not hold the agricultural land in excess of the ceiling areas prescribed therein or otherwise.
3. We understand that even if the document intending to transfer the aforesaid agricultural land is allowed to be registered, we or any member of our family are not absolved of any liabilities in connection with the same under the Urban Land (Ceiling & Regulation) Act, and the provisions of other Acts as above stated and that such transfer will be subject to all provisions of the Urban Land (Ceiling & Regulation) Act and the said other Acts. We also understand that the said Agricultural Land inspire of its transfer as proposed in the aforesaid document may be included in our holding/holding of our family member so required by the provisions or Urban Land (Ceiling & Regulation) Act as and when the Competent Authority decide the statement filed by the Landholder under Section 6(1) of the Act, if any or as and when the issue as to whether there is any surplus land and with us or any member of our family is taken up for consideration.
SCHEDULE OF THE ABOVE PROPERTY
(Give detailed description of the Agricultural Land)
SIGNED AND DELIVERED by the )
Within named (1) ____________________ )
(2) ____________________ )
and (3)_____________________ )
in the presence of …… )
Before me

PART – II
We, (1) ____________________AND (2) _______________, both
of ____________, Indian Inhabitants, do jointly and severally solemnly affirm and declare as under:—
1. That By Deed of Conveyance dated _________ 200__ we have purchased the aforesaid Agricultural Land as described in the aforesaid affidavit of the Transferors.
2. We state that even after the proposed transfer of the said Agricultural land our total extent thereon would be within the ceiling limit as specified under the Urban Land (Ceiling and Regulations) Act, 1976 and/or any provisions of the Acts referred above.
3. We undertake to file a statement u/s 15 of the Urban Land (Ceiling and Regulations) Act, 1976 if the said Agricultural Land is converted to a zone where building activities are permitted or if the said Agricultural Land is converted to non agricultural use and/or if the total extent of land with us exceeds the ceiling limit.

SIGNED AND DELIVERED by the )
Within named (1) ___________________ )
(2) ___________________ )
in the presence of …… )

Before me

NOTE: Suitable changes to be made depending on the facts of the transaction.