APPLICATION FOR HOUSE BUILDING ADVANCE

Name of the Applicant (in block letters) _______________________________

2. Designation (Gazetted/Non Gazetted) ________________________________

3. Father’s/Husband's Name ________________________________

4. Name of Deptt./Branch _______________________________

5. Emolument on which the loan is admissible ____________________________

6. (i) Basic Pay Rs..____________________

(ii) Dearness Pay Rs.__________________

(iii) Special Pay/NPA Rs._______________

(iv) Total (i) to (iii)__________________________

Head of Account _________________________

(i) G.P Fund Accont No.__________________

(ii) Salary Bank _____________________& Account No.__________________

8. Amount of advance applied for________________________________

Recoverable in _________________instalments of Rs.____________

9. Purpose of advance now: applied for_________________________________

10. Whether any advance has been drawn previously for house

building/repairs/Extension of house under any rules/scheme if so:

i. Date of drawal of the advance ___________________________

ii Purpose for which the advance was drawn. ___________________________

iii Amount of advance drawn

EDUNTZ