Application Form for Beneficiary Led Construction
Application Number BR032170125120264575
Applicant Name Sukhiya Devi
Date of Birth 01-Jan-1952
Gender Female
Mobile Number 9093059504
Email Address
Husband Name
Father Name
Employment Status Labour
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.) 85000
Religion Hindu
Marital Status Widow
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 existing house based on roof type Kutcha
Roof Type Thatched Roof (roofs are
made of straw, dry leaves, or
grass)
Page 1
Present Address
House Number Ward 16 Singhia
State Name Bihar
District Name Samastipur
City Name Singhia, Town Panchayat
Street Name Ward 16 Singhia
Pincode 848209
Permanent Address
House Number Ward 16 Singhia
State Name Bihar
District Name Samastipur
City Name Singhia, Town Panchayat
Street Name Ward 16 Singhia
Pincode 848209
Address of the proposed house/Flat under PMAY-U 2.0
House Number Ward 16 Singhia
State Name Bihar
District Name Samastipur
City Name Singhia, Town Panchayat
Street Name Ward 16 Singhia
Pincode 848209
Details of family members
Name Relationship Gender Date of Birth Occupation
with Applicant
SUKHIYA DEVI Self Female 01-Jan-1952 Housewife
Page 2
Bank Details
Account Number ********574
IFSC Code SBIN0003580
Bank Name STATE BANK OF INDIA
Branch Name SINGHIA
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 : SUKHIYA DEVI
Mobile Number : 9093059504
Date : 22/06/2025 09:28:34
Place :
Digitaly signed by Applicant:
Page 4
Self-Undertaking by Beneficiary under BLC
I SUKHIYA DEVI son/daughter/wife of , born on 01-Jan-1952 presently residing in
WARD 16 SINGHIA, WARD 16 SINGHIA ,Singhia, Town Panchayat, Samastipur
,Bihar Mobile/Contact 9093059504 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 atWARD 16 SINGHIA, WARD 16 SINGHIA ,Singhia, Town Panchayat, Samastipur
,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.
Page 5
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 : SUKHIYA DEVI
Date : 22/06/2025 09:28:34
City : Singhia, Town Panchayat
Page 6
