Office ofthe President NATIONAL HOUSING AUTHORITY Northem & Central Luzon Otfice, Eliptioa! Road, Diliman, Quezon City TRE GENERAL MANAGER . Date: NA, Diimen, Quezon City SR: In eocorttance with HHA rules and regulations and provisions of RA 7279 which | and my family agres to comply with faithfully. fam hereby eppiying to purchaseften Project House end Lot Unit Lot___Block_Phase_ A. APPLIGANT'S IDENTITY: (For femete applicant maiden name only) ANE: (Rank) (FirstName) {Widsle Name) (LastName) Residential Address Comm. Tax Cert: Issued On__ issued At Place & Dai of Birth. Ctizenstip:__ BedgeNos______ Contacto: small Address; OfficelUnit Assignment Nemo of Spouse (For vie, give complete melden name): (FirstName) (Wide Name) (Last Nama) Place & Date of Birth of Spouse, B, APPLICANT'S FAMILY COMPOSITION: . NAME RELATION TO APPLICANT civ. STATUS: AGE APPLICANT'S TOTAL FAWILY INCOME PER HONTH: Php D, FANILY REAL PROPERTY HOLDINGS: | and my wio, { ) Donat own nor under coniractio buy any lotdweling unitin the Phiippines {(_} Oun or under eonractio buy the folowing lotsfdweting unis 2 folows; Urban Residential Total Area (60. m.) Commercial & Industrial Total Market Vatue P &. | and mi family nave never avaled of any government housing assistanes/accommodation, nor violated Section sof RA 7270, F. That am nota professional squalier nor a member of squating syndicate. | hereby cerify that | am meking this application forthe sole purpose of acquiring @ homela for my farly and not as ‘DUNKIAY or AGENT of any other party. ‘Any false statement given by me hereinabove shall be sufflent cause for the CANCELLATION of the sward and conizac that maybe executed by NHA in mi favor as @rasut of tis enplication and the foreture of al payments that may have been made therefore without prejudoe to any edministaive criminal er clacton, that maybe brought bythe NHA against me in eccordance with existing is. (Signaaure of Spouse} ‘(Signature of Applicant) SUBSCRIBED AND SWORN to before me in Philppines, this ay of 20__. AFFIANT, having exhibited to me hisiher Community Tax Cartficate as slated above, Doc, Ne, NOTARY PUBLIC Fags No. Book No. Series of 20,PNP ENGINEERING SERVICE APPLICATION PROCESS & CHECKLIST OF REQUIREMENTS FOR PNP HOUSING PROGRAM OF NHA 4. SUBMIT DULY FILLED UP AND NOTARIZED APPLICATION FORMS TO PNP-ES, 2. DULY FILLED UP AND NOTARIZED APPLICATION FORMS WILL BE FORWARDED TO MHA FOR PRE-QUALIFICATION, 3. PRE-QUALIFIED APPLICANTS SHALL SUBMIT THE FOLLOWING REQUIREMENTS IN AN ORDINARY LONG FOLDER WITH TABBINGS: A. SWORN APPLICATION FORM (TO BE PROVIDED BY ES) Tab™A" B. PROOF OF INCOME (ANY OF THE FOLLOWING) Tab *B” Employer's Certificate of Compensation Issued by Finance Service (original) O RIR-Certified Latest Income Tax Retum (original to be presented and photocopy) ©. PROOF OF IDENTITY/CIVIL STATUS Tab“c" for Single Applicants Birth Certificate-Ovvil Registry ar NSO (certified copy and photocopy) PNP ID (original to be presented and photocopy back to back) far Married Applicants Birth Certiicate-Chil Registry or NSO (certified copy and photocopy) Marriage Certificate PNP ID (original to be presented and photocopy back to back) Affidavit of Sepatation-In-Fact -for applicants not legally separated/annulted-(original) D. CERTIFICATE OF DUTY STATUS (ORIGINAL) TAB"D* £. TWO (2) CONSECUTIVE LATEST PAY SLIP TAB“E” (ORIGINAL TO BE PRESENTED & XEROX COPY) [1 F. _ LaTeST SWORN STATEMENT OF ASSETS, LIABILITIES AND NETWORTH TAB YE” (QRIGINAL TO BE PRESENTED & XEROX COPY) Aplece 2x2 id picture Photocopy of cedula Authority to deduct Name of Applicant: Rank Last Name First Name Middle Name Unit Assignment: Contact Number: Specific Project Location: —— — (cut here) — Acknowledgement Receipt Name of Applicants Rank Last Name First Name Middle Name Unit Assignment: Contact Number: ‘Specific Project Location: Received by: Date Received: Visit our Facebook Page: PNNPES Housing Project Call us at: 72-04-01 Loc 5400