HARYANA URBAN DEVELOPMENT AUTHORITY

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No.of Joint Applicants(other than first applicant)

*In case of multiple applicants give their details in a separate sheet as per performa at Annexure-I.

Male

Female

Marital Status

Single

Married

Widow

Widower

Whether earnest money financed

Yes

No

Note: Self addressed envelope attached with the application form may be returned alongwith this application form duly filled in by the applicant.

Yes

HARYANA URBAN DEVELOPMENT AUTHORITY

Urban Est at e

Roht ak

Sect or 6

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C

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2

2

Yes

Department on regular basis.................. 4.. I/We also declare and confirm that I have never been allotted any residential plot directly by HUDA in the Urban Estate........Annexure I: Sr................ *I/We also declare and confirm that I/We own no residential plot/house in my/our name(s) or in the name(s) or my/our dependent family member(s)/Spouse in any Urban Estate of Haryana if applying under any reserve category.... For application downloaded from the website or its photocopy................................... servants reserved quota or discretionary quota................ On allotment I shall produce an affidavit to this effect..........R..... in .. or any other reserved category in any Urban Estate developed by Haryana Urban Estates Deptt................. Rohtak for which I have applied........................... Date ____________ * Conditions applicable for applicants under reserved categories... I/We agree to confirm to abide by the terms & conditions as contained in the Haryana Urban Development Authority Act.........S........ 100/......alongwith earnest money in single draft be deposited failing which the application will be rejected and will not be considered in the draw of lots.... Employees only) 1......... Signature of Applicant(s) Signature of Applicant Note : 1........................... & date of superannuation is/was .... (Haryana Govt............................................... I/We have carefully gone through the terms and conditions for allotment mentioned in the brochure and I/We agree to abide by these terms and conditions...... 1977 and in the rules and regulations applicable there under. iv) There is no plot/house in my name & spouse's name or in the name of any dependant member of my family in any Urban Estate developed by Haryana Urban Estates Deptt................... I attach herewith an affidavit in terms of para 2 above as per item number 12 (iii) of terms and conditions................. am/was employed as.. iii) I fall in category ..........huda........ or HUDA in Haryana State.....Q. Certified that i) I am/was an official of class....................... v) I have not been allotted at any time a plot of land out of Haryana Govt... Applicant Applicant Father's/ Name Surname Husband's Name 1... Also.....gov...... or HUDA in Haryana State..........................in 3......... To.............. failing which my earnest money may be forfeited..... (Refer eligibility condition 12(ii).....................ii) The maximum of my scale of pay is Rs........... an additional fee of Rs........ The Estate Officer Haryana Urban Development Authority Rohtak Dear Sir................ I attach herewith a certificate of employment from the concerned office (HOO/HOD) of Haryana Govt/ Board/ Corporation etc...... Date ... 3... On allotment I shall produce an affidavit to this effect...... Yours faithfully.. 2..............son/daughter/wife of Sh....... Applicants under GSRQ category need to provide additional details as given in Annexure-II............................... Joint Joint Joint Applicant No....................... HUDA-BUILDING A BETTER FUTURE . 2. 2.... I/We request that I/We may be allotted a residential site as stated on reverse side in Sector 6 Rohtak........................ I..... Details of Joint Applicants Joint Applicant Father's/ Husband's Surname Address Address Address State Pin Code Signature Line 1 Line 2 Line 3 Annexure II: Additional Information to be filled in by the applicants under G. For detailed terms & conditions please refer to the information Brochure available on the HUDA Website: www......... Note : Applicant must be regular employee of Haryana Govt/ Board/ Corporation etc...... My date of joining is/was ........