The very best solution and option you have in your hand is to go for your nearest local Panchayat Bhawan or Court Premises where you can get many “Documentation Service Provider” who having all the details and ready formats like you are looking for here.
Well I have enclosed a sample format for you and hope gonna work for you. But still request you to please go to Doc-Service Provider for this.
Second, i request you to visit this link once. Appreciate and validate - Requesting feedback
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