Application for the grant of gratuitous relief/housing subsidy/housing loan to the victims of Natural Calamities report of such victims. I beg to apply for the grant of ............. (State of the nature of assistance) 1.a. Name of the applicant :-_______________________________________________ b. Father's/Husband 's name:-_______________________________________________ c. Age of applicant:-______________________________________________________ d. Present address (residential as well as as business address);-______________________________________________________ 2. Date of loss:-__________________________________________________________ 3.a.If the loss is the dwelling place, Whether the applicant is the owner of the premises:-_________________________________________________________ b. In case of loss of dwelling place estimate loss of :i) the premises:-___________________________________________________________ ii) immovable property, other than ___________________________________________ iii) Movable property:-____________________________________________________ 4. a) In case of loss to business whether the applicant is the owner of the business which sustained loss:-___________________________________________________ b) Was there any branch of the business if so, give complete address:-_____________________________________________ c) Was this the only business carried out by the owner of the business, if Not, give the details of other business:-._____________________________________________________________ 5. a. Business or trade for which the loan gratuitous relief is applied:-________________________________________________ b. Specific purpose and amount of Gratuitous relief/loan required for:-_________________________________________ c. Whether any loan by mortgaging Property or otherwise has been Obtained from any one, if so how much:-________________________________________________________________ 6. The premises of the applicant intends to start his trade or business, in case the applicant has Already started his trade or business the place with full pariculars must be mentioned:-_____________________________________________________________ 7. Has the applicant or any member of his family previously applied for gratuitous relief loan under the Above scheme:-__________________________________________________________ If so, when and what result:-______________________________________________ Date : Signature of the Applicant
