Remigrant Application

Step 1 of 4

25%

Application For

SECTION A: Personal Information

Name(Required)

First Last Other Name(s)

Address(Required)

Street Address Address Line 2 City Country

Email(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Age(Required)

Sex(Required)

Male

Female

National ID#

Passport #(Required)

Martial Status(Required)

Single

Common Law

Separated

Married

Divorced

Widowed

Home Phone

Please enter a valid phone number

Mobile Phone(Required)

Please enter a valid phone number

Office Phone

Please enter a valid phone number

Employment Information

I am employed in(Required)

Public Sector

Private Sector

Self Employed

Other

Employment : Other

Employed From

MM slash DD slash YYYY

Employed To

MM slash DD slash YYYY

Current Occupation

Employed By

Seld-Employed

Please state the type of business you operate

SECTION B: Household Information

Please fill out Spouse information if Applicable:

Spouse Name

First Last Other

Spouse Date of Birth

MM slash DD slash YYYY

Spose Mobile Phone

Spose National ID#

Spose Passport #

Spouse Employment Information

I am employed in

Public Sector

Private Sector

Self Employed

Other

Employed From

MM slash DD slash YYYY

Employed To

MM slash DD slash YYYY

Spouse Employment : Other

Current Occupation

Employed By

Seld-Employed

Please state the type of business you operate

Monthly Household Income (GYD$)

Income of Applicant (Gross)

Income of Applicant (Net)

Income of Spouse (Gross)

Income of Spouse (Net)

Other Income (Gross)

Other Income (Net)

Source of Other Income

Accommodation

Are you a Tenant?

Yes

Monthly Rent (GYD$)

SECTION C: Ownership of Land/House

Do you own a House/Land in Guyana?*

Yes

SECTION D: Allocation of Land

Which Region would you desire your House Lot?

What Category of Land would you prefer?

Low Income (approx. 3200 sq ft)

Moderate Income (approx. 4050 sq ft)

Middle Income (approx. 5000 – 6000 sq ft)

High Income (approx. 6000 – 7200 sq ft)

What type of commercial activity would you operate on the land?

If you applied for a Residential/Commercial Lot.

When offered a lot, how soon can you commence paying?*

Within One (1) Month

Within Two (2) Months

Other

When allocated a serviced lot, how soon can you commence construction?*

Within Two (2) Months

Within Six (6) Months

Within Twelve (12) Months

Other

How soon can you pay : Other(Required)

How soon can you commence construction: Other(Required)

How will you Finance the cost of construction?*

Savings

Remittance

Mortgage

Other

How will you finance : Other(Required)

SECTION E: Community Development

Please indicate your area(s) of interest or skill in contributing to community development:

Interests

Being in a Community Group

Recreational

Environmental

Cultural

Public Health

Self Help

Skills

Leadership

Training

Terms & Conditions

I hereby certify that, to the best of my knowledge, the information provided is true and correct.

I also accept that the Central Housing and Planning Authority reserves the right to take whatever action it considers appropriate including the recission of any allocation granted to me as a result of this application, If the information given by me herein is found to be deliberately false.

Signature

Headquarters

+592 226-5533