ANNEXURE III

Details of PG/Private/Rented Accommodation

Student(s)/Parent(s) Information Details

11719370, Jigdrel Wangmo BA.LLB(Hons) 62 39023522 M F

Student Registration No. and Name
9872288292
Student Contact No. -II
Program Name and Section Student Contact No. -I Gender
ThimThrom, Thimthrom
— 975176647866 Thimphu:Bhutan, 11001
Father Contact No. Mother Contact No. Complete Permanent Address with
City, State, ZIP Code

PG/Private/Rented Accommodation Details

Sanjiv Bhatra 9814525407 8556000662 Lavish Dorms, 102

Name of Owner Owner Mobile No. –I Owner Mobile No. -II PG Name and House No.

None Shreenand enclave mainroad maheru Jazzy properties

No. of roommates from LPU Street No. and Name Landmark and Location

(Mention their Reg. No.’s in case of student and UID in case of

staff/faculty member)

Yes 40 sq. Ft 13500

Accommodation Furnished (Yes/No) Rented Area (in Sq. Ft.) Rent paid per month (per person)

Checklist of features and amenities available at pg/private/rented accommodation

List of features and amenities Availability Status

1. Internet/Wi-Fi connectivity Yes No

2. Power Back-up for 24 hrs Yes No
3. Security Yes No
4. Air Cooled/Conditioned Rooms for whole year Yes No
5. Attached washroom Yes No
6. Water purifier/RO Yes No
7. Maintenance Staff Yes No
8. Lift(s) Facility Yes No
 9. Hygienic Food Facility Yes No
10. Geyser Facility Yes No
11. Laundry Facility with collection points Yes No
12. Guest Room/Temporary Accommodation for Parents Yes No
13. Housekeeping Yes No
14. Any other

Photograph/Map Details of PG/Private/Rented accommodation

List of photographs required ( Building Wise) Attachment Status

1. Front View Refer Annexure – VI, Sample Photograph - 1

2. Left View Refer Annexure – VI, Sample Photograph – 2
3. Right View Refer Annexure – VI, Sample Photograph – 3
4. Inner View Refer Annexure – VI, Sample Photograph – 4
5. Route Map ( From university to place of stay) Refer Annexure – VI, Sample Photograph – 5

Additional documents related to PG/Private/Rented accommodation

List of documents required Attachment Status

1. Copy of acknowledgement
receipt which is received
against the submission of
tenant police verification form to
the police authorities or at
Saanjh Kendra by Owner of
PG/Private/Rented
accommodation.

( To be collected from owner of

PG/Private/Rented accommodation)

VERIFICATION
Verified that the contents and attachments of this document are true to the best of my knowledge and no
part of the document is false and nothing has been concealed or misstated therein.
Date:_______________________________ ________________________

Signature of Father/Mother/Legal Guardian Signature of Student

(Should match with Admission Form)