Lot No. ........................................

Housing Unit Code .....................

Serial No. ....................................

KADUNA STATE GOVERNMENT PASSPORT

PHOTOGRAPH
APPLICATION TO PURCHASE A NON-ESSENTIAL GOVERNMENT HOUSING UNIT (HU) IN KADUNA STATE
Application Type - General Public Free Not for Sale

A. General Information - Individuals

1. Name:
Surname First Name Middle Name Title

2. Demographic:
Date of Birth (DD/MM/YY) State Gender

3. Property of Interest:
Housing Unit Code (see list of Hus) District Street Name House Number Lot No.

B. General Information - Corporate Organization

4. Organizaton's Name:

5. Registration:
Date of Incorporation RC Number TIN Number Type of Organization (Ltd, Plc, Government, NGO etc)

6. Property of Interest
Lot No. Housing Unit Code (see list of Hus) House Number District (see list of Districts) Street Name

C. Contact Address

House Number Street Name, District City/Town, State

Telephone Mobile Email

D. Financial Information
1. Income:
Current Monthly Income Gross Annual Income Taxable Annual Income BVN Number

2. Current:
Current Monthly Rental Payment Current Housing Unit Current Salary Grade Level Years to Retirement

3. Employment:
Current Employer Designation Name of Supervisor

4. Mortgage:
Bid Offer Amount Down Payment Amount Total Mortgage Amount Required

E. Occupation Information (For Kaduna State Public Servants Only)

1. Housing Unit: / /
Date of Allocation Housing Unit Code (see list of HUs) Monthly Rent Deduction Proof of Last 6 Months Rent Deduction

2. Employment: / / / /
Date of 1st Appointment Date of Present Appointment Present Designation Ministry. Department/Organization

F. Bid Information (For General Public Only)

1. Lot No.
Housing Unit Code Bid Offer Amount 10% noon-refundable deposit

2. Bank Draft Details:

Bank Name Draft Number and Date BVN Number PSN Number
Declaration: "It is a punishable offence to provide any false information and or make any false statement or cliam when completing this form. Where it is subsequently
discovered that a housing Unit was purchased based on false or inaccurate information, the Governor may in his sole discretion, invalidate such transactions. The
Government reserves the right to reject any application form not properly or fully completed and shall not incur any liability for any such rejection". The information you
supply on this form is public knowledge and may be published in the media.

Attestation (All Applicants or Authorised Signatory of an organization)

1. Signature: Date:
DD / MM / YY
Completed forms should be returned to:
The Secretariat Office, Committee on Sale of Residential Quarters in Kaduna State, General Hassan Usman Katsina House (State House) Kawo-Kaduna.
Tel: 234(0)9066441154 E-mail:saleofgovthouses@gmail.com
 GUIDELINES FOR COMPLETION
(INDIVIDUALS AND CORPORATE ORGANIZATIONS)

PLEASE PRINT IN CAPITAL (BLOCK) LETTERS, AND SUBMIT THIS APPLICATION WITH THE FOLLOWING AS APPLICABLE

(a) Proof of Payment of Application fee of (g) Letter of appointment into public office OR certificate of
N10,000.00 only payable to KADIRS Revenue election,
Accounts, (h) International Passport, Voters Registration Card,
(b) Letter of Initial employment into the KDSG Civil National Identity card or Driver's License
Service, (i) Pay Slip
(c) Letter of last appointment /promotion in the (j) Tax Clearance from 2014 to 2016
Public Service, (k) Certificate of Incorporation
(d) Letter of allocation of quarters (l) Registration of Business Premises from 2014 to 2016
(e) 4 (four) No. recent high resolution colour
Passport Photographs
(f) Proof of Last 6 Months Rent Deduction

DISTRICT NAME LGA NAME LGA CODE OFFICE USE ONLY

BG
TELEVISION B/GWARI
CH 1. Admin Control Application Serial No.
Lot No.
BARNAWA CHIKUN
GW Mortgage Lender
RIGASA GIWA
IG Winning Bid
NARAYI IGABI
IK Reserve Bid
RIGACHIKUN IKARA
JB Annual Monetized Housing Allowance
KAMAZOU JABA
JM Maximum Loanable Amount
NASSARAWA JAMA'A
KN Minimum Monthly Mortgage Payment
AFAKA K/NORTH
KS Gratuity Payable at Current Salary Grade
BADIKO K/SOUTH
TUDUN WADA/UNGWAN KC Monthly Pension at Current Salary Grade
SANUSI KACHIA
KG Price/Valuation of Property
DOKA/ UNGUWAN SARKI KAGARKO
GABASAWA/ UNGUWAN KJ Bid Bond Amount
RIMI KAJURU
HAYIN BANKI/ UNGUWAN KR Down Payment Amount
SHANU KAURA
KU Balance
KABALA KAURU
KB
UNGUWAN MUAZU KUBAU
KD
BADARAWA/ MALALI KUDAN
OTHERS LR 2. Confirmation Proof of Payment of Application Fee Yes No
LERE
MK Uncompleted Housing Unit Yes No
MAKARFI
SG Proof of Last 6 Months Rent Deduction Yes No NA
S/GARI
SN Letter of Initial Employment Yes No NA
SANGA
SB Letter of Last Appointment/Promotion Yes No NA
SOBA
ZK Letter of Appointment into Public Office Yes No NA
Z/KATAF
ZR Certificate of Election Yes No NA
ZARIA
Letter of Allocation of Quarters Yes No NA

Tax Clearance Certificate for last 3 years Yes No NA

2014 to 2016
Certificate of Incorporation Yes No NA

4 (four) Passport Photographs Yes No NA

Certificate of Registration of
Business Premises in Kaduna State
from 2014 to 2016