Beruflich Dokumente
Kultur Dokumente
*:
Old Prov. Regn. No.*:
HOUSING
BOARD
HARYANA
Flat No.:
C - 1 5 , A W AS B H A W A N , S E C T
TO
O R - 6 , P A NCH K U L A
Bahadurgarh/Sirsa/Narnaul/Bawal Flats
Last date for deposit of the form in the
Concerned bank on or before 0
01.05.2015.
a)
b)
Affix Recent
Passport Size
Photograph
3.
4.
Sex:
5.
Male
Female
YES
NO
6.
YES
NO
7.
8.
YES
NO
(in words)________________________________________
b)
9.
10.
11.
b)
a)
Whether earnest money has been got financed from the Bank
b)
Undertaking:
It is certified that I have carefully gone through & understood the terms & conditions of the scheme
schemes
& public notice do hereby undertake to abide by the same. The above information given in the applicat
application is
true & correct to the best
st of my knowledge & belief & nothing has been concealed therein. I fulfill the
eligibility conditions as laid down in the scheme.
I understand
stand that my name is being considered for registration & allotment (if successful in draw of
lots) without verifying my eligibility by the Board. I understand that in case I am found ineligible at any time,
my registration/allotment shall be cancelled wit
without
hout notice & the amount deposited shall be forfeited as per
terms & conditions given in the brochure.
Name & seal of the Bank/Branch ________________________
Signature of the applicant
Name ________________________
Date _________________________
HOUSING
BOARD
HARYANA
C - 1 5 , A W AS B H A W A N , S E C T
TO
O R - 6 , P A NCH K U L A
Receipt
Received
S/o,W/o,
application
D/o
from
Sh./Smt./Km.
__________________________________________
____________________________________
Bahadurgarh/Sirsa/Narnaul/Bawal
_____________________
vide
flat,
Bank
alongwith
Draft/Cheque
for
the
registration
No.
registration
amount
of
_______________________
_______________/cash.
Date: ________________
Place: _______________
Registration Period:
Bahadurgarh
Sirsa
Narnaul
Bawal
02.03.2010
02.03.2010
04.10.2010
19.02.2010
to
to
to
to
12.04.2010
12.04.2010
04.11.2010
19.03.2010
of
Rs.
dated