FORM – B
Detailed particulars in respect of the families affected by Fire accident / Natural Calamity proposed to be given House Building Grant …………………….Development Block during the year 2021-22.
Memo No: Date:
Present Detailed particulars of
Extent of No. of House Building grant recommended
monthly loss Name of
Name of the head of arable land in Date of houses Whether
Sl Village Police Station income of Gram Bank Account No IFS Code Mobile No
the family possession (in occurrence destroyed or On account of indigent
the family On other Panchayet
acre) damaged damage to Fully Severely Partially Huts
(in Rs.) account
house
Recomandation:
Certified that the above families belong to Below Poverty Level/ are holders of B.P.L. Cards and the total family income of each does not exceed Rs. 2,500/- per month, that the land
where the house is / was located is possessed by the applicant.
Savapati Block Development Officer Sub-Divisional Officer Addl. District Magistrate (Dev)