Annexure CERTIFICATE TO BE FURNISHED BY A GOVERNMENT EMPLOYEE FOR GRANT OF HOUSE RENT ALLOWANCE Particulars furnished by the Officers [SNe | Bescon ofthe mf Oy ; | iat Government accommodation has been provi at selfspouse during the period at ple of onting 2 "Staying in house owned by me/witeson/hitden/ieaintherusband “| Wooo | Within a radius of 8 KM fom Ieadguarter — 3 Staying in house owned by movi snlchildpe/Tahavmotherhusband . | within the limits of the Urban Local Body (Municipal Corporation, | oe | Municipality. Noiied Area Couns of Headquarter | | Ceo. [7 4 T Staying ina hired accommodation within a radius i —_| Headgtarer Pe eN ir | vos |S Stsing in fina accommo win de Tans Tae Uakin Cae VEN | ent. Body (Municipal Corporation, Municipal. Natitied Area Councid of — | = | rtowtooarar OO acc 6 Allowed to retain the Goveranent accomadation amy old place oF posting to rotain my family on payment of wormal renupenal ret Toe the period Th sarees et ee LE | 7 _)My spouse is a Government servant YesNo™ | ned [87 | Whethor widow /nidoweslunmarsiad YewNo | 97M Spouse posted in The save Headquarter ce t gone A si | a | 10 Ny Spouse in ecip oF A (op ee aa *sirike out whieh is not applicable Ga Wthe answer is yes. the period isto be mentioned in Column n0.-2. « oO { certify that the above particulars are true to the best of my knowledge. DAAns De ag Signatyse of the Officer Onin Caer Present local resid (easy mane tial address — nat Nog + No /4Y Seay GageWhether Government accor | sell?spouse during the nt 2 Staying in house eet at place oF posting 2 Staying in house owned b me/wife/son/children/father/motherhusband | Vaso within a radius of 8 KM trom Headquarter 4 Staying in house owned by z/son/el | [within the limits of the Urban L Municipality, Notitied Area Ci Staying in a hired accommodation Headquarter "Staying in a hired accommodation wh | Body (Municipal Corporation, Munie’ [| Headquar a —___i| Allowed to retain the Government accommodation at my old place oF | posting to retain my family on payment of normal renUpenal rent for the | Petiod trom .. 0 | My spouse is a Government servant j 8 | Whether widow widewer/unmarried 9. My spouse is posted in the same Headquarter 10 My spouse is in receipt of IRA *Surike out which is not applicable, @ IT the answer is yes, the period is to be mentioned in Column no.-2. ! cenify that the above particulars are true to the best of my knowledge. Prema Kumar Yen Signature of the Officer Present local residential address a a Designation Plet no. E- 6 (a) bae RB. $2023 ea Bhubonerwev Pin- FEL O14 Js onNS Housing & Ua BovelopmentDet To CENTRAL DIARY No. DATE. a he Under Secretary +0 (ov, 0.€ (Ceckon) Housing 4 Yebun Development Depantert SYbE Cant HOUCE Rent ANowances &. Qin, 600-8 Submicw’an , & be Housing 4 Unley Wy 2ow Chm) ag én Group 'B’ bh dle Poy Ob 200 06 Ane Poy meta’ ond er £9 Punwonce OB Hoste Depantaent altay NY 28404 f occ , Aeconeligely 2 may \indly be rented OS NT MOUSE Ret trewamer ty Pew wiking Prenion Ob Awe Meafeunol Math Su Re. 44 Q06 1 SREP Ruler, 19 A ; 9 tnd fon Why at Of Youn wrelnagy © SCA be Selig d cfovrs $elnguily Bhubanesware Mhencne Date } 03.08, 2023 Cnn Neuttant Oireedon (baw) y MOF ORD 1 2 OSWAS No.Annexure CERTIFICATE TO BE FURNISHED BY A Gi FOR GRANT OF HOUSE RI VERNMENT EMPLOYEE ‘T ALLOWANCE Particulars furnished by the Officers [Remarks overnment accommoda seltispouse during the peri i ichildren/fatherimother/husband | YeNS™ | quarter fe son‘children/t mothe | | ssithin the limits of the Urban Local Body (Municipal Corporation. Municipality, Novfied rea Council) of He ‘adr oF KM am RL Headquarter _ | 3~T Staying in-a hired accommodation wihin the mits of the Urban Local | V&No | Body (Municipal Cenporaion, Moniipali, Noted Area CounelD oF | | Headquarter 5 | Allowed to retain the Government accommodation at my old place of frente | | attic ee " ant Tree = YesiNo Yee?" [1 pouse Wein ree : re | ee Strike out whieh is not applicable. @ Ifthe answer is yes, the period is to be mentioned in Column no-2. | certify thatthe above particulars are tre to the best of my knowledge. Detendan Ch oo nature OF the Officer BSL. Barasunda nem neha Honel rel, Dieser (Les) Pree ihwndag cnt Den - 451603 "03,08, 2023 Oed chordie Cea Cle Mast Das - MOD - 9961/23 6640 Bs AvTo ie Additional Secretary to Government, jousing & Urban Development Deptt., (Odisha, Bhubaneswar. : si Sub: Submission of Application for grant of house rent allowance. Sir, In pursuance of H&UD Deptt. Notification No.12928 dated 19 07.2023 & Office Order No.2538/OWSSB dated 13.07.2023, | have joined as Chief Engineer-cum-Addl. Secretary to Govt, H&UD Deptt. On 44.07.2023 FN. | have been paid house rent allowance from 01 07.2023 to 13.07.2023 for s.2840/- considering the rate of house rent as RS. 6772I- per month applicable for Bhubaneswar Headquarter as per my old pay which has been reflected in my LPG issued by the Administrative Officer, OWSSB vide his letter No.2654 dated 21.07.2023. Now | am submitting herewith the application for grant of house rent allowance from 14.07.2023 to 31.07 2023 as am going to retire on 31.07 2023 on attaining the age of superannuation. “This is for your kind information & necessary action. Encl.; As aboveAnnexure CERTIFICATE TO BE FURNISHED BY A GOVERNMENT EMPLOYEE FOR GRANT OF HOUSE RENT ALLOWANCE Particulars furnished by the Officers in has been provided to the ‘during the period at place of) 2 jo 12 in house owned by me/vife sonvchildren’father/mother/husband “ within a radius of § KM from Headquarter __| n house owned by metwife son‘children/fatherimother/husba Within. the limits of the Urban Local Body (Municipal Corporation. fied Area Council) of Headquarter mmodation within a radius of 8 KM from _ Headquarter _ Staying in a hire ihe Limits of the Urban Local Body (Municipal Corporation. Municipality. Notified Area Couneil) of Headquarter Cl-7 Dcad +0 3\- 7 302?) @ Allowed to retain the ment accommodation at myold piace of | posting to retain my family on payment of normal rentpenal rent for the | @ period from vise... s-0210 4 Whether widow widower/unmarried 9 My spouse is posted in the same Headquarter My spouse is in receipt of HRA *Sirike out which is not applicable. 4 ifthe answer is yes. the period is to be mentioned in Column no-2 | cents that the above particulars are true to the best of my knowledge, here Sea> Signature of the Offic : pete OE carn AAA Secy Plot ale vo @PALaue Sarabds. 1, One B 4 Bhubanegwor , PIN: qT 1oo3 : a7fo1[22 .