Microsoft Word - Application For Grant of Double Bed Room House-Application Form

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APPLICATION FOR GRANT OF DOUBLE BED ROOM HOUSE

Request Details
Food Security Card (FSC Ref) Number: ____________________________________________

Applicant Details
Name of the Applicant *:____________________ Relationship Name(S/O,W/O,D/O):- ________________
Aadhaar Number*: ____________________________ Gender *:  Male  Female
Age*: _____________________________

Details of The All Family Members Including Applicant:

S.No.

Name of the Person

Relation with Applicant

Age

Aadhaar Number

Address for Communication:  GHMC Area / Municipality  Rural


If GHMC Area / Municipality: House No*: ________________________

Mandal*: _______________________________

Village*: __________________________

Ward*: ____________________________

Land Mark*: ________________________

Locality/Area *: ___________________________

Colony *: ____________________________ Pin Code*: _______________________________


If Rural: House No*: ___________________________

Mandal*: _____________________________

Village*: __________________________ Pin Code*: _________________________________


Occupation*: _______________________ Religion*:

Community*:  OC  BC ST  SC  Others

 Hindu  Muslim Christian Others

Present Resident Type*: Own House  Rented  Huts Others


If in case Own house, Mention type of house *: RCC  Concrete Hut  Others
If in case rented house since how many years were staging here :*( Please Provide in Years ex:1.2 or 0.6
..) : ___________________________________________

Family Income*: __________________________

Delivery Type:  Manual

Are there disability person in your family? : -  Yes  No


If yes, mentioned disability Id card Number*: _______________________________________
If already a member of "ASARA Pension Scheme:  Yes  No
If yes, mentioned Aadhaar Number of the pension holder *:

__________________________________

If any member in the family sanctioned a house from the Government:  Yes  No
If yes, sanctioned house number *: ____________________________________________________
House Sanctioned Scheme:  Indiramma -1  Indiramma -2  Indiramma -3  RGK  JNNVRM
 VAMBAY  UPH  Others
Mobile Number*: ________________________ Mail ID: _______________________________________

Documents List:
NOTE:

1.
2.

1. Size of each Upload Document should not exceed 200KB.


2. All Upload Documents should be in PDF Only.

Application Form*
Passport Size photo *

Applicants Signature

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