De-4 Form - Directorate Of Estates Form

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DE-4 FORM
Government of India
Directorate of Estates
Application for Change of Accommodation under S.R.317-B-15
Area Restriction
Technical
Grounds
Regular
Unsafe
Medical
Modification
Others
for Fresh Allotment
Acceptance
for
Change
Registration Number
Allottee Account Number (AAN)
(To be filled up the Applicant if already registered)
(To be filled up the Applicant if allotted)
Date of Receipt
Change Registration Number
(To be filled by Directorate of Estates)
(To be filled up the Applicant in case of Modification of Change)
-
-
TO BE FILLED UP BY THE APPLICANT
INSTRUCTIONS:
Ø
Please fill up the form in BLOCK LETTERS only.
Ø
Fill dates as day (01-31), month (01-12) & year (2002) in the format DD-MM-YYYY.
ü
Ø
Please tick (
) wherever required to do so.
Ø
Applicants should confine their request for change only in respect of road, colony, or locality, floor (ground / first floor etc.) and / or
another design of construction. Any other preferences mentioned in the application will be ignored.
Ø
Please enclose copy of allotment letter in case of Technical Acceptance.
Ø
In case of Area Restriction for Fresh Allotment, please fill up separate DE-4 form for each type.
Ø
Pools available
GP : General Pool
SC: SC Pool
ST : ST Pool
TP : Tenure Pool
LS : Ladies Single Pool
LM : Ladies Married Pool
1.
Name
Shri / Smt ./ Km / Ms / Dr
2.
Designation
3.
Department /
Oraganization
4.
Ministry
5.
Accommodation of Directorate of Estates currently occupied
Type
Locality
Sector
Block
Quarter No
House ID
Date of Priority for the Type
Date of Occupation
-
-
-
-
TP / GP / SC / ST
LS / LM
Pool under which you were allotted
accommodation
6.
Choices for Change of Accommodation
Quarter Type in case of
Area Restriction for Fresh Allotment
Locality
Construction
Number of
Sector
Block
Floor
Design
Rooms
a)
b)
c)
7.
Address of Place of Duty of the Applicant
8.
Permanent address (if any)
Phone
Fax
Phone
E-mail

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