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Mobile Dustbin Rent

Full Name *

Mobile No. *

Email ID *

Present Address *

Address Where Dustbin Toilet Will Be Stationed *

From Date * *

To Date * *

No. Of Days *

No. Of Dustbins *

Approx Sq. Mt *

Charges *

Note : Cleanliness Charges of Rs.2/Sq.mt. of function area (subject to minimum of Rs. 100/) + Transportation charges of Rs. 100 + Security deposit(Security deposit refundable)

Id Proof(Aadhaar Card/ Voting Card/ Pan Card) *

Address Proof *

Note : Cleanliness deposit of Rs.2/Sq.mt. of function area (Cash or Debit card/ Credit card or Cheque/DD in favour of Chief Officer, Silvassa Municipal Council)