Application for Land/Property

Application For:

Section A

Personal Information

First Name

Other Name

Last Name

Address

Address Line 1

Address Line 2

City

Country

Date of Birth

Age

Sex

Male

Female

Old National ID Number

New National ID Number

Passport Number

TIN Number

Martial Status

Single

Common Law

Seperated

Married

Divorced

Home Phone

Mobile Phone

Office Phone

Employment Information

I am Employed in

Public Sector

Private Sector

Self Employed

Other

Please state other option.

Employed from:

Employed By

Employed to:

Self-Employed

Current Occupation

Section B : House Information

Please fill out Spouse Information if applicable.

First Name

Other Name

Last Name

Date of Birth

Passport Number

Mobile Phone (Spouse)

Old National ID #

New National ID #

Spouse Employment Information

I am Employed in

Public Sector

Private Sector

Self Employed

Other

Please state other option.

Employed from:

Employed By

Employed to:

Self-Employed

Current Occupation

Persons Living with the Applicant (PLWA)

First Name

Last Name

Relationship to Applicant

ID Number / Passport #

Date of Birth

Occupation

First Name

Last Name

Relationship to Applicant

ID Number / Passport #

Date of Birth

Occupation

First Name

Last Name

Relationship to Applicant

ID Number / Passport #

Date of Birth

Occupation

First Name

Last Name

Relationship to Applicant

ID Number / Passport #

Date of Birth

Occupation

First Name

Last Name

Relationship to Applicant

ID Number / Passport #

Date of Birth

Occupation

First Name

Last Name

Relationship to Applicant

ID Number / Passport #

Date of Birth

Occupation

First Name

Last Name

Relationship to Applicant

ID Number / Passport #

Date of Birth

Occupation

First Name

Last Name

Relationship to Applicant

ID Number / Passport #

Date of Birth

Occupation

Monthly House Income (GYD$)

Income of Applicant

Income of Spouse

Other Income

Source of Other Income

Accomodation

Are you a tennant?

Yes

Other

Please state option here

Monthly Rent (GYD$)

Are you squatting?

Yes

If Yes, please state where you are squatting:

Section C

Ownership of Land/House

Have you ever applied for a house lot?

Yes

If yes, please state year

Do you own a land?

Yes

If yes, please give particulars.

Do you own a house?

Yes

If yes, please give particulars.

Are any of the persons in Section B owners of/or have rights in freeland or leasehold property of any type?*

Yes

If Owned, give particulars below:

First Name

Last Name

Particulars

First Name

Last Name

Particulars

First Name

Last Name

Particulars

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?

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

Within Two (2) Months

Within Six (6) Months

Within Twelve (12) Months

Other

Please state other option here

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

Within Two (2) Months

Within Six (6) Months

Within Twelve (12) Months

Other

Please state other option here

How will you Finance the cost of construction?

Savings

Remittance

Mortgage

Other

Please state other option here

Section E : Allocation of House

What type of House would you prefer?

Core House (approx. 312 Sq Ft.)

Single Flat House (approx. 600 Sq. Ft)

Bungalow House - Single Flat (approx. 118 Sq. Ft)

Duplex House - One of Two Apartments

Other

Please state other option here

Section F: Community Development

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

Interest

Being in a Community Group

Recreational

Environmental

Cultural

Public Health

Self Help

Skills

Leadership

Training

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

Sign Here

Headquarters

+592 226-5533

Section A

Personal Information

Employment Information

Section B : House Information

Please fill out Spouse Information if applicable.

Spouse Employment Information

Persons Living with the Applicant (PLWA)

Persons Living with the Applicant (PLWA)

Monthly House Income (GYD$)

Accomodation

Section C

Ownership of Land/House

If Owned, give particulars below:

Section D : Allocation of Land

Section E : Allocation of House

Section F: Community Development

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