10/06/2019 DDA HOUSING SCHEME-2019

Delhi Development Authority Form Number

DELHI DEVELOPMENT AUTHORITY Form No.

D V. Pvt. Application form for residential plan - 2019 715668

APPLICATION FORM FOR DDA HOUSING SCHEME - 2019
1. (A) Name of the applicant (A) Name of the Applicant
AAKANKSHA DHEERAJ
Applicant
(B) Photo
(B) Gender Male Male Female Female Opposite sex
gender
(C) Date of Birth (C) Date of Birth
07-12-1986
Applicant
2. Name of applicant's father Name of Applicant's Father Signature
ANOOP KUMAR UPADHYAY

3.
Name of the applicant's wife / husband (if married) Name of Spouse
Applicant Joint
of Applicant (if married) Photo

DHEERAJ CHANDRASEKHAR

4. Applicant's PAN Number PAN No. of Applicant Applicant Joint

ABVPU6667K Signature
5. Applicant's Bank Name: Applicant's Bank Name (as per Clause 11 - Refund to Unsuccessfull Applicants)
HDF

Name of applicant's bank branch

YUSUF SARAI COMPLEX

Bank Account Number Bank A / c No 50100028648344

IFSC Code IFSC Code HDFC0001664

6. Telephone no. (With STD code) Phone No. (with STD Code)

7. Mobile no. Mobile No 8447730477

8. Aadhaar No. Adhaar No

9. Email-ID Email-ID aakankshaupadhyay86@gmail.com

10.Category Code Category Code (as per column 9 of Specific Instructions) GE - GENERAL

11.(A) Resident Address of the applicant (A) Residential Address of Applicant

N-572, SECTOR 8, RK PURAM, NEW DELHI-110022

PIN 110022

(B) area (B) Region Delhi Delhi Outside Delhi outside Delhi
(C) Nationality (C) Nationality Indian indian Other Other
12.Address of correspondence address Address for Correspondence
B-10, GROUND FLOOR, SHEKHAR APARTMENT, MAYUR VIHAR PHASE 1 EXTENSION, DELHI-110091

PIN 110091
13.(A) Name of joint applicant / s - Optional (A) Name of Joint Applicant - Optional
DHEERAJ CHANDRASEKHAR
(B) Relation (in the case of reserved category) (B) Relation (In case of Reserved category)
(as per Clause 2 (XI) or Clause 2 (XII) of eligiblility)
Husband
14.(
A) Name of the wife / husband - If both husband and wife apply differently (A) Name of the Spouse, if both
husband & wife apply separately
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(B) Application form of wife / husband number if applied separately

(B) Application No. of the Spouse, if applied separately

15.Position of priority Positions (with code)

(a) First Preference First Preference 31 - MIG - VASANT KUNJ
SECTOR B TO E CLUSTER
(b) Second Priority Second Preference 41 - LIG - VASANT KUNJ
2,3,5,6
BLOCK BLOCK E, D, C_B
(c) Third Preference Third Preference CLUSTER 2,3,5,6
(d) Fourth Preference Fourth Preference

(e) Fifth Preference Fifth Preference

(f) Sixth Preference Selection Preference

(g) Seventh Priority Seventh Preference

16.Registration details of the amount

Registration amount details Date Amount Payment Mode
17.NEFT / RTGS details
Details of NEFT / RTGS etc. Ref. / Acc No Bank Name
18. I / We hereby declare that the above information is true according to my / our entire information and none of
these information is false and has not been hidden. I / We have carefully read and understood the contracts and
conditions and instructions given in this brochure and to agree to it, I agree / I / we will fulfill the eligibility criteria
given in the brochure to apply under this scheme. I do / know / I know that if it is found that I / We are not eligible
as per the prescribed conditions in section 2 of the brochure. I / We have taken a false advantage of reservation or
false affidavit / no false information, or hidden any important facts at any time, then my / our application / letter /
allocation rejected / canceled without issuing a show cause notice Will go. I / We also know / know that such
cancellation cases
I / We hereby declare that the information given above is true to the best of my knowledge and nothing is false and
no material / information has been hidden from there. I / We have carefully read and understood the terms and
conditions contained in the instructions and hereby agree to abide by them. I / We meet the eligiblity criteria given
in the brochure to apply under the scheme. I we know if it is found that if I am / are not eligible as per conditions
laid down in clause 2 of the brochure or have falsely claimed the benefit of reservation or has given false affidivat /
information including quotation incorrect number PAN number or suppressed any material fact at any time whatever,
the application / allotment (s) will not reject / cancelled summarily without issuing any show cause notice for the
same. In case,

Date Date: 10-06-2019

Place Place: Signature of Applicant Signature of Applicant Joint Applicant Signature of Joint Applicant

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