NAYA PAKISTAN HOUSING PROGRAM م ا گر و پر سنگ ؤ ہا ن کستا پا نیا

NAME - As Stated in CNIC / �����  ��  �  �

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CNIC NUMBER / �  ������  ��

MOBILE NUMBER / �  ���� �� PHONE NUMBER - RESIDENCE / �  �

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PROFESSION / �

GOVERNMENT EMPLOYEE / ������  ����� PRIVATE SECTOR EMPLOYEE / ��

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�������� SELF EMPLOYED / ����� ������ ���

FARMER / �

�� LABOR / ���������� OTHERS / ���

CURRENT RESIDENCE / ����  �����

JOINT FAMILY HOME / �  �� RENTAL HOME / �  �  ���� KATCHI ABADI / ������ ��ٓ�  �

TOTAL FAMILY GROSS INCOME ( PKR / MONTH ) / ���ٓ�  ���  �  �  �

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LESS THAN 20,000 �  � ٢٠٠٠٠

FROM 20,001 TO 40,000�

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FROM 40,001 TO 60,000�

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FROM 60,001 TO 100,000�

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ABOVE 100,000��������

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NUMBER OF RESIDENTS EXPECTED TO LIVE IN THE HOUSE / �  ���  �  �  ���  �  �����  �  ���������  ��

DESIRED LOCATION OF HOUSE / ��  ��  �  �  �

TOWN - VILLAGE / ���

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CITY - UC / � - �� �� TEHSIL / �

I solemnly affirm that there is no concealment or misrepresentation of facts stated herein above.

SIGNATURE OF THE CANDIDATE / ���  �  �����  �

��������� DATE / �������

SIGNATURE OF THE OFFICIAL / ���  �  �����  ��  ����  ����  �

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Preference will be given to candidates who do not own any independent residential unit in Pakistan. �  �  �  ��  �  �  ���  �  �

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Only one person per family ( husband, wife and children ) is eligible to apply in this scheme. �  ���  �  ��� �

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PKR 250 per form should be deposited along with this registration form. ����  �  ����  �  ����� 250 �  ����  �

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It is compulsory to fill every field. Please fill this form in ENGLISH using BLOCKLETTERS. ��   ������  ����  ����  �  ����  ����  �  

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SERVICE CODE / ����  ���� NUMBER / �

1

2

3 4

1.

2.

3.

4.

5.

5

6

7

9 1 2 3 4 5 6 7 8 9 10

FOR MORE THAN 10, MENTION THE NUMBER

10

11

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REGISTRATION FORM NUMBER / �  ����  ����

DD MM YYYY

DATE / �������

FOR OFFICE USE ONLY / �  �  ����  ����

REGISTRATION FORM NUMBER / �  ���� ����

( PLEASE TICK ONLY ONE - �   �����  �  ����� )

FOR

OFF

ICE

USE

ON

LY

INCLUDE AREA CODE ALONG WITH PHONE NUMBER - ��  �����  �

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OTHERS / ���

( PLEASE TICK ONLY ONE - �   �����  �  ����� )

( PLEASE TICK ONLY ONE - �   �����  �  ����� )

( PLEASE TICK ONLY ONE - �   �����  �  ����� )

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DD MM YYYY���� � ����

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CNIC NUMBER / �  ������  ��

An Amount of Two Hundred and Fifty Rupees ( PKR 250 )has been received.

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YOUR PREFERRED MONTHLY INSTALLMENT PLAN ( PKR / MONTH ) / �  ��� ��  �   ���ٓ�

FROM 5,000 TO 10,000�

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FROM 10,001 TO 15,000�

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FROM 15,001 TO 20,000�

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8 ( PLEASE TICK ONLY ONE - �   �����  �  ����� )

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SWAT / �

���� FAISALABAD / ����� ��ٓ�  � SUKKUR / � GILGIT / � QUETTA / �� MUZAFFARABAD / ����� ��ٓ�� ISLAMABAD / ����� ��ٓ�  �����

SELECT ONE DISTRICT FROM THESE OPTIONS / ��   �����  � �����  �  �  �����  ��

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ii iii

iv

250

This form is for registration only. �  �  �  ����  ����  �

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����  ��  ��  �  ����  ��� Based on the data collected from these forms, housing specification including design,

price and site will be decided for the applicants.

6.