Application Form Name of the Applicant Name of Spouse/Father Date of Birth Aadhar/PAN Community(for statistical purposes only)GeneralOBCSCST Designation Office Address Address for Communication Designation of Head office / DDO Date of appointment / No. of Years’ Service Completed Date of Retirement/Superannuation Monthly Income/Salary Contact Number Email Total amount that the applicant can afford to buy a plot/ whether bank loan is expected Whether owning a house/ House Site (indicates the area) RemarksI declare that the above said particulars are true and correct to the best of my knowledge.