Beneficiary Survey Form for all verticals of PMAY - U 2.

Application Number BR032191224134205411

Applicant Name SUNAINA DEVI
Pan Card
Date of Birth 05-Apr-1991
Gender Female
Husband Name jitendra Bind
Father Name
Mother Name
Employment Status Labour
Occupation of the applicant Labourer
Education Qualification No Education
Household Category EWS
Whether the family owns puccca house any where in No
India.
Average annual household income (in Rs.) 45000
Religion Hindu
Marital Status Married
Category OBC
Special Focus Group No

Preferred component of Scheme BLC

No of years residing in the present city/town More than 10 Years
House Ownership
Type of exisiting house based on roof type
Roof Type

Present Address

House No 032
Street Name AT-KOYARIBIGHA,PO-
BARBIGHA,PS-BARBIGHA
City Name Barbigha
District Name Sheikhpura
State Name Bihar
Mobile Number 6207658140
Email Address
Pincode 811101

Permanent Address

House Number 032

Street Name AT-KOYARIBIGHA,PO-
BARBIGHA,PS-BARBIGHA
City Name Barbigha
District Name Sheikhpura
State Name Bihar
Mobile Number 6207658140
Email Address
Pincode 811101

Address of the proposed house/Flat under PMAY-U 2.0

House Number 032

Street Name 032
City Name Barbigha
District Name Sheikhpura
State Name Bihar
Mobile Number 6207658140
Email Address
Pincode 811101
 Details of family members

Name Relationship Gender Date of Birth Occupation

with Applicant
SUNAINA DEVI Self Female 05-Apr-1991 Labourer
jitendra Bind Husband Male

Bank Details

Account Number ********10129786

IFSC Code PUNB0055500
Bank Name PUNJAB NATIONAL BANK
Branch Name BARBIGHA, DISTT.
MONGHYR (BIHAR

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.
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 : SUNAINA DEVI

Mobile Number : 6207658140

Signature of Applicant

Date : 29-12-2024 01:57:29

Place :
 Pradhan Mantri Awas Yojana – Urban 2.0 (PMAY-U 2.0). Self-Undertaking by
Beneficiary under BLC

I SUNAINA DEVI son/daughter/wife of , born on 05-Apr-1991 presently residing in 032,

AT-KOYARIBIGHA,PO-BARBIGHA,PS-BARBIGHA ,Barbigha, Sheikhpura ,Bihar
Mobile/Contact 6207658140 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 <strong>
3,00,000/- (Rupees Three Lakh Only).

3. That I am the owner of the land/property with valid documents where the construction is proposed
situated at032, 032 ,Barbigha, Sheikhpura ,BiharThe said land is free from all legal disputes and is
suitable for the construction of house under the PMAY-U 2.0 Scheme.

4. 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.

5. 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 i.e. Twelve (12) Months from the date of receipt of first instalment
under the PMAY-U 2.0 Scheme.

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 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 of my house.

8. That I have not applied/availed benefit under any other vertical of PMAY-U 2.0

9. That I shall adhere to all terms and conditions of the PMAY-U 2.0 Scheme.
 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.

Name : SUNAINA DEVI

Date : 29-12-2024 01:57:29
City : Barbigha