Rffil ~CflIB SIllfilCfl '( UI

D E L H I D E V E L O P M E N T A U T H O RI T Y
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Form No.
~.tcr:!Il.311C11('il4 m.m - 2014 cf; fI; ro: ~ '!fQ'; f APPLICATIONFORM FOR DDA HOUSING SCHEME 2014
(mq; 31&mfi ~ TO BE FILLED IN CAPITAL LETIERS)
1. ~ q; J 'iJ lI Name of the Applicant
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2. ~ *Iilffi q; J 'iJ lI Name of Applicant's father:
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3. ~ ~ 'IOft; 'lflI q; J 'iJ lI ~ ~ ~) Name of Spouse of Applicant (if married)
Photograph of Applicant
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4. ~ q; J iI'f 'l'<R
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PAN No. of Applicant:
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5. ~ *~~lmq; J 'iJ lI Applicant's Bank Account & Branch
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~ <m!I li. BankNc No.:
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311~~q; ~~fll m IFSC Code:
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6. ~ 'i. (~ m*WI ) Phone No. (with STD Code)
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7.~'i. Mobile No.:
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8.~ Email-Id:
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PhOlogtat>h 0 1 J oint Applicant.
9. - ! fI m Gategory code:
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Ha n y
t O . ~ q; J 311llm\l!1lill Residential Address of Applicant
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I P It I N I
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t 1. 'iii ~ q; J 'Iffi Address for correspondence:
Name of J oint appucant- optional
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(a) ~ (3iRI l I ~ ~ W~) Relation (In case of Reserved category) I I I I I I I I
t3. (0;) 'IOft; 'lflI q;J 'iJ lI - ~ 'lflI ~ '10ft z y n 3IW1~ ~ qffiI ~ Name of the Spouse. if both husband & wife apply separately
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(li) 'IOft/'lflI q;J ~ 'iii mt. ~ 3IW1~ ~ qffiI ~ Application No. of the Spouse. Kapplied separately
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t4. ~ *~ ~ JW) Locations Preference (write code) W t' I I I ~ 2'" I m3'" LI -'---'
tS. ~ <1ftJ q;J ~ ~;~ t)q; li. _ filfll _ <1ftJ _ _ ~.. .. lm_ ,_ _
Registration amount Oraft/Bankers Cheque No Oate Amount Drawn on Branch ..
, 6. "".~.~.tl./~ ~ *11m'! Details of NEFT/RTGS etc ..
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.... r .ot _ _ {lI 'I /.. "'...... """_ .... I !o!_ I ~'O ! ... _ "'l"...I I... I 'I /.. """{I """'I O >I .!........ tlO _ ... ,I _ .",."l"'1/ .... 'I CI {I '.Wm
.,."," ... "'"lim,...... """,/ti ~i"" el.~* ...olI ~..,& ....! iii ~/"" .m.../.... olI ... <ll3I'!lft<Io(.I fI,; ~_ /~ ..I\<l_ ,ljl'l",~"""{I 'I l'lI l11O~~.
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"We her eby declar e lh3t!he inlor malion given al>Qveis: tr ue 10 the best of my knQ.1edgeand nou- .ng I s talSe andnomate~O I 'r N tion haS been conceale<l tr I er eI ton\ V I N etI M car etu~ lU I and U I 'lde~O O CIt!'le ter ms
and ~s c~ "'lhe BrochureaiO O O vllth instn.aons and hereby a~e 10abi6e by them. lM'e Mill the eligibi:ity etI1erfa~n in the SrocI'ue to.,pr y un6erthe SCheme.I know " it is 10I.I'IdIMl if W/e have
appliedalthOugh Wle amtare no! eligible as per conditiOnS laiO dO wn iIclause 2 01 the Broctue or have fat:sefy daimed the bendil of ~ othas given latse altiOrlitf.,IOflTlaliOn inCluding QUoMg WTong PAN Number
or suppr e:s.wd< t I I ' f mr .e:r iallac! at J Itry time 'III~ the applk:atiolV allotmenl(S) wi! be r ej eetC<V canceledsummar iy without issuWlg air ! Show cause nodce tor the same. I ncase. 01such canoeI :aticI V 'r ej r dion all
~depostedagainsttheapplica:ion(sy allolmer t(s)$baI ber or 1e~ed.
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Date ,--I -,---,I ,--I-'-_ J
*r nm Signatureof Applicant ~m ~~SignaltJ reof J oint Applicant
m Ptace ..
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Application received on with the above mentioned particulars.
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Authorised signature of the Bank Official with seal
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ACKNOWLEDGEMENT SLIP
Rffil ~CflIB SIllfuCfl '( UI
D E L H I D E V E L O P M E N T A U T H O RI T Y
~~
Form No.
ft::.f<f:lIT_ 311C1I(; flll ~ - 2014 <f; fto!l( ~lftI; j' APPLICATION FORM FOR DDA HOUSING SCHEME 2014
(f.lUfflH ifu; '[m'1m - ;;r r o: TO BE FILLED BY DESIGNATED BANK)
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Name of the applicant .
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Specimen signature of applicant ..
~ <1ftJ q;J m ~;~ t)q; li. _ filfll _ <1ftJ _ ~...... .. lm_ ,_ _
Registration amount OrafVBankers Cheque No Oate Amount Drawn on Branch ..
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Application received on wtlh the above mentioned particulars.
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Authorised signature of the Bank Official with seal