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House Requisition Form ENGLISH

The document is a house requisition form requiring personal details, employment information, and housing preferences from the applicant. It includes sections for verifying the applicant's current housing situation and conditions for allotment. The form must be completed accurately to avoid cancellation of the application and future claims for housing.

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kapillamboraoffice
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228 views1 page

House Requisition Form ENGLISH

The document is a house requisition form requiring personal details, employment information, and housing preferences from the applicant. It includes sections for verifying the applicant's current housing situation and conditions for allotment. The form must be completed accurately to avoid cancellation of the application and future claims for housing.

Uploaded by

kapillamboraoffice
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

// HOUSE REQUISITION FORM //

Full Name: ________________________________ (Male / Female), Date of Birth: ______________


Category (attach attested photocopy): ___________, Specially Able Person (Yes/No, attach attested photocopy)
Present Address: ____________________________________________________________
____________________________________________________________
Permanent Address: _________________________________________________________
__________________________________________________________
Mobile no.: _________________ Phone no.: _______________ Fax no.: _____________
Present Designation: ________________ Department: _________ Present Pay Band:_____________
Basic: ___________Grade Pay: _________ HRA: ___________ Total Salary: ______________
Date of Joining in Present Cadre / Post: _______________________ Institute: GEC / NITR
Details of First / Initial Joining in Govt. Service / Job:
Designation: ________________ (GEC / NITR), Date: ____________ Place: ____________
Date of taking Charge in NITR, Raipur: _____________________

Vacant Quarters requested in order of priority:


1 ____________________ 2 ______________________ 3 ______________________
4 ____________________ 5 ______________________ 6 _______________________

Whether applicant has a House within Raipur Municipal Corporation area owned by Self / Wife /
Husband / Family? (Yes / No) _____ (if Yes, attach details).

If any other Government House is allotted in name of Husband / Wife? (Yes/No) (if Yes, attach details)

In case I fail to occupy the allotted House within 10 days from the date of issue of allotment order or information given above
is found to be incorrect, allotment shall be cancelled and I shall forfeit future claims for allotment / change of Accommodation
for One Year and shall pay commercial rent, if did not vacate the earlier quarter within 15 days after taking possession of fresh
allotted quarter.

(Incomplete application will not be entertained) Signature of Applicant

Forwarded

Signature of Head, Name & Seal

Verification of above Information by Gazetted / Non-Gazetted Establishment:


(If any amount is being recovered, please specify its type & monthly deduction)

Signature, Name, Designation & Seal

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