(Related to Sub-rule(2) of Rule 26)
Government of Nepal
Ministry of Land Reform and Management
Department of Survey
Permit for the Surveying

Signature of the person attesting photo
(To be signed on the photograph)
Serial Number of the permit :–

This permit has been issued to the following person in the recommendation made on date ………… by the examination (inquiry) committee formed pursuant to Rule 21 of land (survey) Rules, 2058, in condition of
obeying (following) the terms specified in Land (survey) Act, 2019 and Land (survey) Rules, 2058 on date ………………….. and allowing to perform the following survey activities.
Details of the person receiving the permit,–
Name surname :–
Address :– District : ………. VDC/Municipality: ………….. Ward No. …..
Citizenship Certificate No. and Date :–
Office Issuing the Citizenship Certificate :–
Father’s Name :–
Signature :–
Permitted Activities related to survey :–
Certificate issuing officers,–
Name :–
Designation :–
Signature :–
Date :–

(Source: Nepal Law Commission)

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