Information Of Beneficiary Being Covered Under Slum Rehabilitation (Page 4 of 4) in pdf

Information Of Beneficiary Being Covered Under Slum Rehabilitation Page 4

15. Number of Years of Stay in this Town/City

[0 to 1 year -01, 1 to 3 years- 02, 3 to 5 years- 03, More than 5 years-04]

16. Size of existing dwelling unit (Carpet area in square

meters)

Person with Disability

17. Whether

(Yes/No)

18. Marital Status[Married-01, Unmarried-02,

Single woman/Widow-03]

19. Whether the family owns any house

anywhere in India (Yes/No)

a. If yes, then location details

(Locality/City/State)

b. If yes, then extent of land in Sq.mtrs

20. Employment Status

(Self Employed – 01, Salaried – 02, Regular Wage – 03, Labour – 04, Other – 05)

21. Average monthly income of household (in Rs.)

22. Does the family have a BPL Card (Yes / No)

a. If yes, Provide BPL Card No

23. Housing requirement of family

(New House – 01, Enhancement – 02)

24. In case of enhancement, please specify enhancement

required [One room/Kitchen/Bath/Toilet or combination of these]

25. Preferred component of Mission under which beneficiary need assistance

under HFA

Credit linked subsidy - 01

ii.

Affordable Housing in Partnership - 02

iii.

Beneficiary-led individual house construction/enhancement - 03

26. Abridged Houselist TIN (from SECC)

(If assistance under Beneficiary-led individual house construction/enhancement)

Signature/Thumb Impression of Head of Household

Note: * Same format shall be used for ineligible slum dwellers and beneficiary of those slums, which have

not been considered for slum redevelopment through Private Participation as per process flow chart of

HFAPoA at page No.17 of the “Housing for All” Scheme guidelines.

Signature of representative of ULB in-charge

of above information

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Information Of Beneficiary Being Covered Under Slum Rehabilitation Page 4