Application Form for Affordable Housing in Partnership
Application Number HR020700525116303340
Applicant Name Manju
Pan Card FOBPM0061K
Date of Birth 01-Jan-1993
Gender Female
Mobile Number 8307406088
Email Address
Husband Name Prem Pal
Father Name Aneg Singh
Mother Name Mindro Devi
Employment Status Other
Occupation Housewife
Education Qualification No Education
Household Category EWS
Whether the family owns puccca house anywhere No
in India.
Average annual household income (in Rs.) 75000
Religion Hindu
Marital Status Widow
Category SC
Special Focus Group No
Preferred component of Scheme AHP
No of years residing in the present city/town More than 10 Years
House Ownership No House
Type of existing house based on roof type
Roof Type
Page 1
Present Address
House Number House No 168
State Name Haryana
District Name Panchkula
City Name Kalka, Municipality
Street Name Rampur Seuri Bcw Surajpur
Pincode 133302
Permanent Address
House Number House No 168
State Name Haryana
District Name Panchkula
City Name Kalka, Municipality
Street Name Rampur Seuri Bcw Surajpur
Pincode 133302
AHP Project Location Details
IS AHP Project Identified YES
Project Code 0
State Name
District Name
City Name
Details of family members
Name Relationship Gender Date of Birth Occupation
with Applicant
Manju Self Female 01-Jan-1993 Housewife
Mindro Devi Mother Female
Page 2
Bank Details
Account Number ********00064943
IFSC Code PUNB0639500
Bank Name PUNJAB NATIONAL BANK
Branch Name AMRAWATI ENCLAVE
PANCHKULA
Have you availed benefit under any Central/State No
sponsored Schemes such as AMRUT 2.0, SBM-U
2.0 DAY-NULM, NHM, PM Surya Ghar: Muft Bijli
Yojna, Ayushman Bharat,Ujjwala Yojna, Ujala etc.
Page 3
Aadhaar Consent by the Applicant
Note 1: All details should be filled up as per Aadhaar only.
Note 2: Consent for Aadhaar Authentication:
a) I hereby state that I have no objection in authenticating myself with Aadhaar based
authentication system and give consent to provide my Aadhaar number, Biometric
and/or One Time Password (OTP) data for Aadhaar based authentication for the
purposes of availing benefits of owning a pucca house under Pradhan Mantri Awas
Yojana - Urban 2.0 (PMAY-U 2.0). I understand that the Aadhaar number, Biometrics
and/or OTP provided for authentication shall be used:
i. for authenticating my identity and
ii. for de-duplication with the previous housing Scheme, PMAY-U 2.0 (all verticals
including Interest Subsidy Scheme) and also for de-duplication with other housing
schemes such as PMAY (Gramin), any State sponsored housing schemes etc.
b) I understand that PMAY-U 2.0, Ministry of Housing and Urban Affairs, Government
of India shall ensure security and confidentiality of my personal identity data provided
for the purpose of Aadhaar based authentication.
c) I hereby declare that the information provided hereunder is correct.
Name : Manju
Mobile Number : 8307406088
Date : 18-05-2025 11:35:53
Place :
Digitaly signed by Applicant:
Page 4
Self-Undertaking by Beneficiary under AHP
I Manju son/daughter/wife of Aneg Singh, born on 01-Jan-1993 presently residing in
House no 168, Rampur Seuri BCW Surajpur ,Kalka, Municipality, Panchkula ,Haryana
Mobile/Contact 8307406088 by solemnly affirm and declare as under:
1. That there is no pucca house in my name or any family member name in any part of India.
2. That I belong to EWS category, as my annual household income from all sources is up to
3,00,000/- (Rupees Three lakh Only)
3. That I or my family member have not availed benefits under any other housing Scheme of the
Government of India or State Government in last 20 years.
4. That I am willing to contribute my share of money for the construction of my house under PMAY-
U 2.0, within stipulated time period as mentioned in Agreement under the PMAY-U 2.0 Scheme.
5. That I shall not sell-out/transfer the house constructed under PMAY-U 2.0 Scheme for a period of
Five (5) years from the date of completion/registration/ allotment/possession of my house.
6. That I shall use the house constructed under PMAY-U 2.0 Scheme only for residential purpose
and shall not use for any other activities.
7. That I shall adhere to all terms and conditions of the PMAY-U 2.0 Scheme.
8. That I have not applied/availed benefit under any other vertical of PMAY-U 2.0.
I hereby declare that all the above information provided by me in the application form is true and
correct to the best of my knowledge and belief. I also understand that non-compliance with respect
to eligibility or submission of false information will lead to legal consequences, including but not
limited to, disqualification from the Scheme and recovery of any benefits already received under
PMAY-U 2.0 Scheme.
Page 5
Name : Manju
Date : 18-05-2025 11:35:53
City : Kalka, Municipality
Page 6
