REGISTRATION FORM NUMBER / �  ���� ����

FOR OFFICE USE ONLY / �  �  ����  ����

NAYA PAKISTAN HOUSING PROGRAM ‫ﻧﯿﺎ ﭘﺎﮐﺴﺘﺎن ﮨﺎؤﺳﻨﮓ ﭘﺮوﮔﺮام‬

1. This form is for registration only. �  �  �  ����  ����  �
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2. Based on the data collected from these forms, housing specification including design, �  ���  �  �  �  ������  � ، ���������  �  ����  �  ���  �  ���  ��  ��  �  ����  ���
price and site will be decided for the applicants.
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3. Preference will be given to candidates who do not own any independent residential unit in Pakistan. �  �  �  ��  �  �  ���  �  ������  �����  �  �  �  ��  ���  ��  �  ���  ���
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4. Only one person per family ( husband, wife and children ) is eligible to apply in this scheme. �  ���  �  ��� ���������  �  �  ���  �  �����  �����  ��  �  � ( �  ������  �� ، ����) �����  �����
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5. PKR 250 per form should be deposited along with this registration form. ����  �  ��� �  �  ����� 250 �  ����  ���������  �
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6. It is compulsory to fill every field. Please fill this form in ENGLISH using BLOCKLETTERS. ��  ��� ���  ��� �  ����  �  ���  ��� �  �  �������  ��� ����� - �  ��� �  ���  ���  ��  �� ��  �  ����  ���������
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1 NAME - As Stated in CNIC / ����  ��  �  ��� ��  ��

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2 CNIC NUMBER / �  ��� ��  ��

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3 MOBILE NUMBER / �  ������ 4 PHONE NUMBER - RESIDENCE / �  ��  �  ����

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SERVICE CODE / ��
�  ���� NUMBER / � �  �  ���  ����  �  �  ��
INCLUDE AREA CODE ALONG WITH PHONE NUMBER - ��  ����  ��

5 PROFESSION / � ( PLEASE TICK � �  �  ����� )

ONLY ONE - �  ���
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GOVERNMENT EMPLOYEE / �����  ����� PRIVATE SECTOR EMPLOYEE / �����  �  ���������  ������� SELF EMPLOYED / ����������� ���

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FARMER / �� LABOR / �������� � OTHERS / ���

6 CURRENT RESIDENCE / ����  ����� ( PLEASE TICK � �  �  ����� )

ONLY ONE - �  ���

JOINT FAMILY HOME / �  �� RENTAL HOME / �  �  ���� KATCHI ABADI / ��������ٓ�  � OTHERS / ���

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7 TOTAL FAMILY GROSS INCOME ( PKR / MONTH ) / ���ٓ�  ���  �  �  ����� ( PLEASE TICK � �  �  ����� )
ONLY ONE - �  ���

LESS THAN 20,000

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FROM 20,001 TO 40,000
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FROM 40,001 TO 60,000
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FROM 60,001 TO 100,000 ABOVE � 100,000
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8 YOUR PREFERRED MONTHLY INSTALLMENT PLAN ( PKR / MONTH ) / �  ��� ��  �  ��

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ONLY ONE - �  ���

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FROM 5,000 TO 10,000 FROM 10,001 TO 15,000 FROM 15,001 TO 20,000
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9 NUMBER OF RESIDENTS EXPECTED TO LIVE IN THE HOUSE / �  ���  �  �  ���  �  �����  �  ���������  �� 1 2 3 4 5 6 7 8 9 10
( PLEASE TICK � �  �  ����� )
ONLY ONE - �  ��� FOR MORE THAN 10, MENTION THE � NUMBER
10 DESIRED LOCATION OF HOUSE / ��  ��  �  �  � ��  �����  �  �  ���������  � ١٠ ���

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i SELECT ONE DISTRICT FROM THESE OPTIONS / ��  ���
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FAISALABAD / �������ٓ�  � GILGIT / � QUETTA / �� MUZAFFARABAD / �������ٓ�� SWAT / ���� ISLAMABAD / �������ٓ�  ����� SUKKUR / �

ii TEHSIL / � iii CITY - UC / � - �� ��

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iv TOWN - VILLAGE / ������ - ����

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11 I solemnly affirm that there is no concealment or misrepresentation of facts stated herein above. �  �  �  ����  ���  �  �  ��  ����  ��� ���  �����  �  ��  ����  �  �  �����  ���  �

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SIGNATURE OF THE CANDIDATE / ���  �  �����  ��������� DATE / ������
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DD MM YYYY
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CNIC NUMBER / �  ��� ��  �� REGISTRATION FORM NUMBER / �  ����  ����
FOR OFFICE USE ONLY

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SIGNATURE OF THE OFFICIAL / ���  �  �����  ��  ����  ����  ���������
An Amount of Two Hundred and Fifty Rupees ( PKR 250 )
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DATE / ������ has been received.
�  �  �  ����  ���  �  ����� 250
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DD MM YYYY
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