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Elliot Residencies-Application Form

This document appears to be an application form for a middle income housing project administered by Sri Lanka's Urban Development Authority. It requests personal details from applicants such as name, address, contact information, national identity number, marital status, profession and details of any joint applicants. It also requests employment history, salary information and certifications from employers. The form notes the types of houses available - A, B and C, which differ by number of bedrooms and bathrooms. It requires signatures and dates from applicants.

Uploaded by

Vindula Ranawaka
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© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
60 views

Elliot Residencies-Application Form

This document appears to be an application form for a middle income housing project administered by Sri Lanka's Urban Development Authority. It requests personal details from applicants such as name, address, contact information, national identity number, marital status, profession and details of any joint applicants. It also requests employment history, salary information and certifications from employers. The form notes the types of houses available - A, B and C, which differ by number of bedrooms and bathrooms. It requires signatures and dates from applicants.

Uploaded by

Vindula Ranawaka
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Modern Living at the Heart of the Borella City

House Reservation Application Form


Middle Income Housing Project

Urban Development Authority

6th Floor, Sethsiripaya,

Battaramulla.

MINISTRY OF URBAN DEVELOPMENT, COAST


CONSERVATION, WASTE DISPOSAL AND
COMMUNITY CLEANLINESS
Office Use Only
Application Number Date Time

Supporting Documents
1. Fully Completed Application Form
2. Copy of National Identity Card (Applicant’s and Joint Applicant’s)
3. Proof of Present Address (Current Utility Bill)
4. Last Four Months’ Salary Slips

Application Form
Personal Details
Name in Full (Mr./Mrs./Miss/DR/Dr./Prof./Rev.)

Name with Initials


Last Name
Gender (please Male Female
tick)
Date of Birth DD MM YYYY Age
NIC/Passport No. (Please attach a certified copy of NIC)
Postal Address Permanent Address

Telephone Home Mobile Office


Electronic Mail
Marital Status Single Married Divorced
Profession
Joint Applicant's Details (Spouse/Father/Mother/Son/Daughter/Other)
Name in Full (Mr./Mrs./Miss/DR./Dr./Prof./Rev.)

Name with Initials


Last Name
Gender (please tick) Male Female
Date of Birth DD MM YYYY Age
NIC/Passport No. (Please attach a certified copy of NIC)
Postal Address Permanent Address

Telephone Home Mobile Office


Electronic Mail
Profession
Employment & Service Experience
Employer Sector Address Telephone Position Period Service
Held From To in years
1 dd/mm/yyyy dd/mm/yyyy

2 dd/mm/yyyy dd/mm/yyyy

3 dd/mm/yyyy dd/mm/yyyy

4 dd/mm/yyyy dd/mm/yyyy

Sector=Self/Private/Public

Monthly Income & expenditure


From occupation (Please attach last 04 months salary pay slips) Total (Rs.)
Earnings Deductions
Basic Salary EPF/ETF
Fixed Allowances Taxes
Overtime/Holiday pay Loans/Interests
Others Others
Total earnings Total Deductions

Other Income
Total
(If self employed, please attach last year Profit & Loss or Income & Expenditure account)

Employer’s Certification (Should be filled by a managerial level position)


I certify that the above particulars are true and correct as per the service records.
Name with initials
Designation
Employer
Employer’s Address
Contact Number

Signature Date DD MM YYYY

House A B C
Type
Floor (03-28) *BR-02 * BR-03 * BR-03
*Bathroom-02 * Bathroom-02 * Bathroom-02
* Maid room with Bathroom

……………………………………. …………………………
Signature of the Applicant Date

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