Form K': Declaration by Owner/Occupier (See Sub-Rule (2) of Rule 38) Declaration

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FORM ‘K’: DECLARATION BY OWNER/OCCUPIER

[See sub-rule (2) of rule 38]

DECLARATION

It is hereby declared that the …………………………(name of the building or premises)


located…….……………………………………………………………………..(address)
comprised of ……………….. basement (s) and …………………… (upper floors) have
complied with the fire prevention and fire safety requirements in accordance with rule 33
of the Delhi Fire Service Rules, 2010 and issued Fire Safety Certificate vide Computer
ID NO. …………………for a period of …………………… years in accordance with
rule 36 valid from …………………… to ………………….and the fire prevention and
fire safety measures provided in the building/premises have been checked by me / in my
presence by Fire Safety officer on …………………….. and found them in place and in
good repairs.
It is further declared that no additions or alterations have been made in the
building/premises affecting the fire prevention and fire safety measures including the
means of escape and that all exits and passages are free from any obstruction.

(Signature of owner /occupier)

Name in Block Capitals……………………………..

Address…………………………….
Counter signed

(Fire Safety Officer*)


Name………………………………..

* Strike out whichever is not applicable.

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