APPLICATION FORM OF PMAY
1 Name of head of the family
2 Sex [Male: 01, Female: 02]
3 Father's Name
4 Present Address and Contact Details
i House/Flat/Door No.
ii Name of the Street
iii City
iv Mobile No.
5 Permanent Address
i House/Flat/Door No.
ii Name of the Street
iii City/Village
iv District, State
6 Ownership details of existing house
[Won-01, Rent-02, Otherwise-03]
7 Type of the house based on roof type
[Pucca (CC & Stone Slab)-01, Semi-Pucca
(Asbestos/Steel Sheet, Tiled)-02,
Katcha(Grass/thatched, Tarpaulin, Wooden)-03]
Number of rooms in the dwelling unit excluding
8
kitchen
1
9 Aadhaar Card, if not available
Voter ID Card/Any other unique identification number
or a certificate of house ownership from Revenue Authority of beneficiary's native district
10 Number & age of family members
Aadhaar Card, if not available Voter ID Card/Any
Relationship to Head of the other unique identification number or a certificate
Gender Age
Family of house ownership from Revenue Authority of
beneficiary's native district
11 Religion
[Hindu-01, Muslim-02, Christian-03, Sikh-04, Jainism-
05, Buddhism-06, Zoroastrianism-07, others (specify)]
12 Caste
[General-01, SC-02, ST-03, OBC-04]
13 Bank Details
a Bank account number
b Name of the Bank & Branch
14 Number of Years of Stay in this Town/City
[0 to 1 year-01, 1 to 3 years-02, 3 to 5 years-03, More
than 5 years-04]
Size of existing dwelling unit (Carpet area in
15
square meters)
2
Whether the family owns any house/residential land
16
anywhere in India (Yes/No)
c If yes, then location details
(Locality/City/State)
d If yes, then extent of land in Sq. mtrs
17 Employment Status
(Self Employed-01, Salaried-02, Regular Wage-03,
Labour-04, Other-05)
18 Average monthly income of household (in Rs.)
19 Does the family have a BPL Card (Yes/No)
a. If yes, Provide BPL Card No.
20 Housing requirement of family
(New House-01, Enhancement-02)
In case of enhancement, please specify enhancement
21
required
[One room/Kitchen/Bath/Toilet or combination of these]
Preferred component of Mission under which
20
beneficiary need assistance under HFA
i Credit linked subsidy -01
ii Affordable Housing in Partenership-02
iii Self construction -03
Signature/Thumb Impression of Head of Household
Note: * Same format shall be used for ineligible slum dwellers and beneficiary of those slums, which have not
been considered for slum redevelopment through Private Participation as per process flow chart of HFAPoA at
page No. 17 of the "Housing for All" Scheme guidelines.
Signature of representative of ULB in-charge of
above information
