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DETAILS OF PG/ PRIVATE/ RENTED ACCOMMODATIONS Passport size
coloured
STUDENT(S)/PARENT(S) INFORMATION DETAILS Photograph of PG
Owner
(To be filled by the students staying outside university premises)
Student Name Dilpreet Singh Rekhi VID/ Reg.No. 12303520
Programme Name B.tech Computer Science
Section K23MZ Gender Male Female Student Contact No.-I 9918927011
StudentContactNo.II Father Contact No. 9918927011 Mother Contact No. 6394011031
PERMANENT ADDRESS
City/Town
Distt. State/Province Country â
Zip/ Postal Code
PG/PRIVATE/RENTED ACCOMMODATION DETAILS *•
Name of Owner S/D/O PG Name. House No.
*No. of roommates from LPU Street No. and Name Landmark and Location
Owner Mobile No.-I Owner Mobile No.-II No. of rooms in accommodation
Accommodation Type: Room Apartment Dormitory
Accommodation Pattern: 1 seater 2 seater 3 seater Any other
Accommodation Furnished No Rented Area (in Sq. Ft.) Rent paid per month (per person)
Yes
*(Mention their VID/ Reg.No.’s in case of student and UID in case of staff/faculty
member)
Checklist of features and amenities available at pg/private/rented accommodation
List of features and amenities Availability Status
Internet/Wi-Fi connectivity Yes No
Power Back-up for 24 Yes No
hrs Security Yes No
Air Cooled/Conditioned Rooms for whole Yes No
year Attached washroom
Water purifier/RO
Maintenance Staff
Fire NOC
Lift(s) Facility
Hygienic Food Facility
Geyser Facility
Laundry Facility with collection points
Guest Room/Temporary Accommodation for Parents
Housekeeping
Any other
Photograph/Map Details of PG/Private/Rented Accommodation
The student needs to submit 5 photographs of his/ her rented accommodation covering front view, left view, right view, inner view
and route map (from university to place of stay). The sample of the same can be obtained from Division of Admissions.
Additional documents related to PG/Private/Rented accommodation
List of documents required Attachment Status
(Sample Acknowledgement Slip)
1. Copy of acknowledgement receipt
which is received against the submission of
tenant police verification form to the
police authorities or at Saanjh Kendra by
Owner of PG/Private/Rented
accommodation.
(To be collected from owner of PG/
Private/Rented accommodation)
2. Copy of fire safety certificate which is received against the fire safety details submitted to Punjab Fire Services by owner of
PG/ Private/ Rented Accommodation (To be collected from Owner of PG/ Private/ Rented Accommodation)
3. Proof of (PG owner) residence (Passport/ Voter Identity Card/ Ration Card/ Driving License/ Aadhaar Card/ Electricity Bill/
Telephone Bill/ Bank Account Statement etc.)
VERIFICATION
Verified that the contents and attachments of this document are true to the best of my knowledge and no part of the document is
false and nothing has been concealed or misstated therein.
Date:
Signature of the Parent/Legal Signature of Applicant
Guardian (Should match with
Admission Form)
