Scribd Logo
Upload

Welcome to Scribd!

  • 78 views

    TLTB 5C Form English Version

    Uploaded by

    Lagiono Sovanivalu
    This document is an application form for individual lease distribution from the Itaukei Land Trust Board. It requests identification details like name, date of birth, tax ID number, photo ID. It also requests contact details like addresses and phone numbers. Employment details if applicable are requested. Payment details like bank account name and number are needed. The applicant authorizes the ITLB to pay their share of rent, premiums and other income to their nominated bank account and declares the information provided is true.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    TLTB 5C Form English Version

    Uploaded by

    Lagiono Sovanivalu
    78 views1 page
    This document is an application form for individual lease distribution from the Itaukei Land Trust Board. It requests identification details like name, date of birth, tax ID number, photo ID. It also requests contact details like addresses and phone numbers. Employment details if applicable are requested. Payment details like bank account name and number are needed. The applicant authorizes the ITLB to pay their share of rent, premiums and other income to their nominated bank account and declares the information provided is true.

    Original Title

    TLTB-5C-Form-English-Version

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is an application form for individual lease distribution from the Itaukei Land Trust Board. It requests identification details like name, date of birth, tax ID number, photo ID. It also requests contact details like addresses and phone numbers. Employment details if applicable are requested. Payment details like bank account name and number are needed. The applicant authorizes the ITLB to pay their share of rent, premiums and other income to their nominated bank account and declares the information provided is true.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    78 views1 page

    TLTB 5C Form English Version

    Uploaded by

    Lagiono Sovanivalu
    This document is an application form for individual lease distribution from the Itaukei Land Trust Board. It requests identification details like name, date of birth, tax ID number, photo ID. It also requests contact details like addresses and phone numbers. Employment details if applicable are requested. Payment details like bank account name and number are needed. The applicant authorizes the ITLB to pay their share of rent, premiums and other income to their nominated bank account and declares the information provided is true.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 1

    TLTB 5C FORM (ENGLISH VERSION)

    ITAUKEI LAND TRUST BOARD Insert Certified Passport Size Photo

    Individual Lease Distribution Application Form

    Name
    Tokatoka
    Village
    District
    Province

    A. Identification Details
    Date of Birth (Attach Birth Certificate)

    Tax Identification Number (TIN #) (Attach copy of TIN Letter or FNPF/FIRCA Joint Card)

    Valid Photo ID # (Attach: D/Licence, EVR ID,Passport, Tertiary Student ID or Social Welfare Asst. ID)

    B. Contact Details
    Residential Address
    Postal Address
    Mobile #
    Residential #
    Fax #
    Email address

    C. Employment Details (if applicable)


    Occupation
    Name of Current Employer

    D. Payment Details
    Bank Account Details
    Bank Account Name (Attach Bank Statement copy , bank support letter

    Bank Name OR passbook)

    Bank Account #

    E. Authorisation & Declaration


    I, _______________________________________ being a person entitled to the Tokatoka __________________________
    share for the individual distribution in the village of _________________, District of ___________________, in the Province of __________________
    HEREBY AUTHORISE AND INSTRUCT I TAUKEI LAND TRUST BOARD to pay my share of the present and future rent, premiums,royalties
    and other land derived income directly to my nominated bank account number ___________________________________
    held with ________________.
    I declare that all information provided to I Taukei Land Trust Board on this form is true and correct. I have read, understood and agree
    to the matters set out on this form and I undertake to idemnify the I Taukei Land Trust Board of all liabilities from actions that may arise out of any
    disagreement over this authority.

    Name Signature/Thumbprint Date

    Witnessed By:

    Name Signature Date

    FOR OFFICE USE ONLY:

    Registered By: (Attach system Printout)

    Name & Position Held Signature Date

    You might also like