Bharat Sanchar Nigam Limited

(A Govt. of India Enterprise)

Eastern Telecom Region
Kolkata 700073

Application for allotment/Change of Telecom Pool Departmental Quarters

APPLICATION MUST BE VERIFIED BY THE OFFICE WITH PROPER SEAL AND SIGNATURE

1. Name ( In Block Letters) : SUDIP MONDAL

2. Caste : GENERAL

3. Designation in full & Office address : JUNIOR ENGINEER, O/O THE SDE OFC
MTCE./BANKURA
4. Head of Office: DGM (M), ETR, KOLKATA.

5. Present Residential Address : VILL.-JOYNAGAR, P.O.-PALASDANGA, DIST.-BANKURA,

PIN.-722208

6. Date of entry in the Dept. & period of continuous service: 10TH JULY,2017

7. Particulars of Salary Disbursing Officer : A.O., O/O DGM(M), ETR, KOLKATA

8. (a) Date of Birth : 30/04/1991

(b) Date of Superannuation :

9. (a) Basic Pay : RS. 13600.00

(b) Rate and Date of next increment : DNI @ 3% 01/05/2018

10. (a) Type of Quarter eligible : TYPE - II

(b) Location of quarters : BANKURA OFC COMPOUND

11. Whether official is entitled to rent free accommodation : NO

As a condition of service

12. Whether any residence or part of it owned by applicant : NO

or by any member of his/her family within the limits
of Kolkata Municipal Corporation and adjoining Municipal
areas (if so, give particulars.)

13. Whether husband/wife of the applicant is in occupation : NO

Of any Govt. accommodation (if yes, state particulars)

14. Particulars of Govt. accommodation if any at present : N/A

(No. of Qtr., type, location)
15. Indicate in which category you belong to:
(a) Non transferable :
(b) Transferable (i) Divisional basis
(ii)Circle basis CIRCLE BASIS
(iii) All India basis

DECLARATION

I, Shri/Smt.___SUDIP MONDAL________declare that the particulars given by me above are

correct and that the allotment to be made to me shall be subjected to the allotment rules and
subsequent amendments, if any, made thereof.

(a) I furthered declared that I have read the C.G.M Eastern Telecom Region, Kolkata Office
circular No. CGM/ETR/R-3/CA/Allotment/2001-2002 dated 01-01-2001 and noted the
contents there

(b) I or any member of my family does not own any residence or part of it within the limits of
Calcutta or adjoining Municipal areas.

(c) If it is found that the accommodation is misused, I shall be liable for eviction forthwith as per
provision in the Public Premises (Eviction of Unauthorized Occupants) Act, 1971 and also
liable for punishment as per C.G.S (Conduct rule).

(d) I shall neither share the Govt. accommodation with any other person/persons nor sublet the
accommodation wholly/partly without prior permission from the competent authority.

(e) I shall vacate the Govt. accommodation without fail within a period of permissible limits
either on retirement/transfer or on being declared as unauthorized occupant by the competent
authority.

Dated: _________________ Signature of the applicant in full

APPLICATION MUST BE VERIFIED BY THE HEAD OF THE OFFICE

(FOR OFFICE USE ONLY)

No. _________________ Dated: ___________________

Forwarded to the Chief General Manager, Eastern Telecom Region, Kolkata 73 for favour
of disposal. The statement given above by the applicant has been verified and forwarded after
necessary correction. He/She has been placed under suspension w.e.f ___N/A___. He/She has
not been placed under suspension.

Signature:

Designation:

Dated: ________________ Office:

 Foot Note: Entitlement of Quarter (As per revised scale)

(a) Type-I - Basic pay upto Rs. 4549/-

(b) Type-II - Basic pay upto Rs. 4550/- to below 7800/-
(c) Type-III - Basic pay upto Rs. 7800/- to below 11,020/-
(d) Type-IV - Basic pay upto Rs. 11,020/- to below Rs. 14,500/-
(e) Type-IV (Spl.) - Basic pay upto Rs. 14,500/- to below Rs.
(f) Type-V
(g) Type-V(B)