Consent Form Ministry of Rural Development, Government of India Pradhan Mantri Awas Yojana - Gramin Consent for Authentication 1. ___ Thereby state that I have no objection in authenticating myself with Aadhaar based authentication system and give my consent to provide my Aadhaar number, Biometric and/or One-Time Password (OTP) data for Aadhaar based authentication for the purposes of process involved in availing benefits of Pradhan Mantri Awas ‘Yojana-Gramin [PMAY-G]. I understand that the Aadhaar number, Biometrics and/ or OTP, provide for authentication shall be used:~ a. for authenticating my identity and; b. for de-duplucation with other housing schemes like PMAY-URBAN [PMAY-U}. ¢. To assess my eligibility across Government programmes MGNREGS / PMAY-Grameen I. Lunderstand that PMAY-G, Ministry of Rural Development, Government of India shall ensure security and confidentiality of my personal identity data provided for the purpose of Aadhaar based authentication. I. I hereby declare that the information provided hereunder is correct. ° Name : 1 Sfo (or) Wio. Je. Wen ben Sumo Oo Masked Aadhaar Number : xxxx xx GAd6L 6093 2% Mobile Number :_ol629 2068 Enclosure; Self-attested copy of the Aadhaar ID. Signature of the applicant S roo AS. Q ate: 13] + ]29 ap: Dowell? manda. U2 (For Official Use) or Registration No. (ifany) Scanned with CamScanner