General Administration Department, Government of Mizoram, India

APPLICATION FOR ALLOTMENT OF GOVERNMENT QUARTERS UNDER

GENERAL ADMINISTRATION DEPARTMENT

1. Name of applicant : ………………………………………………

2. Permanent Residence/Address : ………………………………………………...

3. a) Designation : ………………………………………………...

b) Pay Band & Grade Pay : ………………………………………………...

c) Date of attaining the present Grade Pay : ………………………………………………...

5. Date of posting/joining in the present post/

Station : ………………………………………………...

6. Name, Number, Type and place of Quarters

Applied for or preferred, if any : ………………………………………………...

7. A. Marital Status of the Applicant : ………………………………………………...

If married:

(a) Name of Spouse : ………………………………………………...

If employed under the state Govt.

(b) Designation : ………………………………………………

(d) Regular/Work charge/Contract/MR: ……………………………………………….

B. Other member(s) of Family residing

with him/her who is/are employed

under the State Govt.

(a) Name : ………………………………………………...

(b) Designation : ………………………………………………...

(d) Regular/Work charge/Contract/MR: ……………………………………………….

8. Whether the applicant has a house of his

own or not at the same station : ………………………………………………...

9. Whether the applicant has been allotted : ………………………………………………...

quarters previously (if so, place with number ………………………………………………

of quarters should be stated with reasons …………………………………………………

for re-allotment)

10. REMARKS : ………………………………………………...

I certify that the above statements are true to the best of my knowledge.

PLACE : ………………………….

DATE : ………………………….

Signature of applicant

Contd…2/-

2 -

(to be given by employer while recommending application for allotment of

Government Quarters)

This is to certify that the Grade Pay of Shri/Smt. …………………………………….. Designation ………………………………………….of the office of ………………………………… …………………………………………. Is ` …………………….. (Rupees ………………………….. ……………………………………….....) only in the Pay Band of ` ……………………………........

He has not owned a house at the station of posting where the quarters applied for is located.

Also certified that the applicant has been in my office since ……………………….. ………………………….. (date, month & year) without break.

Hence, the application for allotment of Type …………………………. Of Government quarters is recommended.

1. Signature of Head of Department/Office

NAME ……………………………………..

Designation Seal

2. Signature of DDO (if different from No. 1)

NAME ……………………………………….

Designation Seal

No. …………………………………………………… Dated ………………………………..

1. The Under Secretary, General Administration Department

Govt. of Mizoram