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Borang Permohonan Penyewaan Gambar Program Perumahan Rakyat (Ppr) Pemohon

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Borang Permohonan Penyewaan Gambar Program Perumahan Rakyat (Ppr) Pemohon No. Daftar Permohonan : Tarikh Daftar : BORANG INI DIBERI PERCUMA LEMBAGA PERUMAHAN DAN HARTANAH PERAK TEL : 05-2095054 / 05-2095542 FAX : 05-2530001 SILA LEKATKAN BORANG PERMOHONAN PENYEWAAN GAMBAR PROGRAM PERUMAHAN RAKYAT (PPR) PEMOHON SAMBUNG PENYEWAAN PERMOHONAN BARU SYARAT KELAYAKAN PEMOHON: 1. Warganegara Malaysia; 2. Berumur 18 tahun ke atas; 3. Pendapatan isi rumah tidak melebihi RM 3,000.00; 4. Belum memiliki rumah. 5. Permohonan sambung sewa hanya akan dilanjutkan kepada penyewa yang mempunyai rekod bayaran yang baik, masih belum memiliki rumah dan pemohon atau ahli keluarga tiada rekod jenayah. SENARAI SEMAK DOKUMEN SOKONGAN 1. Sila lampirkan sesalinan dokumen berikut :- i. Kad Pengenalan pemohon dan tanggungan; ii. Sijil Pendaftaran Pernikahan,Sijil Pendaftaran Perceraian atau Sijil Kematian pasangan yang mana berkaitan; iii. Sijil Kelahiran anak-anak/keluarga dalam tanggungan; iv. Slip gaji pemohon dan pasangan(bagi kakitangan kerajaan dan swasta) atau Pengesahan Pendapatan daripada Penghulu Mukim, ADUN atau Pesuruhjaya Sumpah sekiranya bekerja sendiri; PERHATIAN 1. Semua maklumat WAJIB DIISI dan borang yang tidak lengkap akan DITOLAK. 2. Wajib diisi bahagian bertanda ** 3. Borang yang telah lengkap beserta lampiran hendaklah dihantar ke: Lembaga Perumahan dan Hartanah Perak, Aras G, Bangunan Perak Darul Ridzuan, Jalan Panglima Bukit Gantang Wahab, 30000 Ipoh, Perak Darul Ridzuan. A. RUMAH YANG DIPOHON ** Sila tanda ( / ) dalam kotak berkenaan Rumah Pangsa Jalan Hospital, Ipoh Rumah Pangsa Taman seri Gemilang, Tapah Pangsapuri Seri Kepayang, Ipoh Rumah Pangsa Taman Seri Bidor, Bidor Rumah Pangsa Jalan Pasir Puteh, Ipoh Taman Desa Idaman, Sungkai Rumah Pangsa Buntong Permai, Ipoh Taman Bernam Permai, Tanjung Malim Taman Mesra Rakyat, Kampar Rumah Pangsa Taman Toh Jabit, Parit Buntar Pangsapuri Simpang Perdana, Taiping Taman Desa Cempaka, Pengkalan Hulu Program Perumahan Rakyat Kamunting Pangsapuri Laksamana Aman Jaya, Teluk Intan B. MAKLUMAT PEMOHON ** 1. Nama : _______________________________________________________________________________ 2. No. Kad Pengenalan : (Baru) ________________________ (Lama) _____________________________ 3. Tempat Lahir : ____________________________________________________ 4. Agama : Islam Buddha Hindu Kristian Lain – lain(nyatakan)_____ 5. Bangsa : Melayu Cina India Lain – lain (nyatakan)____________________ 6. Taraf Perkahwinan: Kahwin Duda / Janda Bujang 7. Kecacatan ( Jika ada ) : ________________________________________________________________ 8. Jenis kediaman sekarang : Sewa Setinggan Tumpang Rumah Sendiri 9. Alamat Kediaman Sekarang : ______________________________________________________________ _____________________________________________________________________________________ 10. Alamat Surat Menyurat : _________________________________________________________________ (Sekiranya berlainan dengan alamat diatas) _____________________________________________________________________________________ 11. a) No. Telefon Rumah : ______________________ 12. a) No. Tel. Bimbit :_______________________ b) No. Telefon Rumah Waris : ________________ b) No. Tel. Bimbit Waris :__________________ 13. Pekerjaan : ____________________________________________________________________________ 14. Nama & Alamat Majikan : ________________________________________________________________ _____________________________________________________________________________________ 15. No. Telefon Pejabat : ________________ 16. Pendapatan Bulanan i) Pemohon : RM _____________________ ii) Pasangan : RM ____________________ iii) Jumlah Pendapatan : RM __________________ (suami + isteri) (Perlu disertakan salinan slip gaji atau pengesahan pendapatan oleh Penghulu / ADUN / Pesuruhjaya Sumpah) 17. Lain-lain pendapatan atau bantuan kewangan dari Jabatan Kebajikan Masyarakat/ Baitulmal / NGO: RM _______________ C. MAKLUMAT PASANGAN 1. Nama : ______________________________________________________________________________ 2. No. Kad Pengenalan : (Baru) ________________________ (Lama) ____________________________ 3. Tempat Lahir : __________________________________________________________________________ 4. Bangsa : Melayu Cina India Lain – lain (nyatakan)_____________ 5. No. Telefon Bimbit : _____________________ 6. Kecacatan (Jika ada) : _________________________ 7. Pekerjaan : ____________________________________________________________________________ 8. Nama dan Alamat Majikan :_______________________________________________________________ ______________________________________________________________________________________ 9. No. Telefon Pejabat : ___________________________________________________________________ D. MAKLUMAT TANGGUNGAN (Perlu disertakan salinan sijil kelahiran / Mykid / Mykad) NO SIJIL KELAHIRAN / HUBUNGAN BIL NAMA PENUH NO K/P (suami / isteri / anak) E. PEMILIKAN HARTA ** 1. Memiliki rumah: Tiada Jika Ada, nyatakan alamat : _________________________________________ ________________________________________________________________ 2. Memiliki tanah kediaman: Tiada Jika Ada, nyatakan hakmilik : ________________________________ ____________________________________________________________ 3. Kenderaan : Tiada Jika Ada, nyatakan :- BIL JENIS KENDERAAN NO. PENDAFTARAN F. PENYEWAAN PERUMAHAN RAKYAT NEGERI PERAK ** 1. Pernah menyewa/: Tidak menumpang Jika Ya, nyatakan nama Program Perumahan Rakyat : ____________________ 2. Tempoh menyewa / menumpang (Tahun) : ______________________________________________ G. PERAKUAN PEMOHON MENURUT ’AKTA AKUAN BERKANUN 1960’ ** Saya .................................................................................................. No. K/P ............................................. dengan sesungguh dan sebenarnya mengaku bahawa segala maklumat yang diberikan di dalam permohonan saya untuk menyewa Program Perumahan Rakyat adalah benar. Sekiranya sebarang keterangan yang diberikan adalah didapati palsu, Lembaga Perumahan dan Hartanah Perak berhak membatalkan permohonan ini dan tindakan mahkamah boleh diambil terhadap saya. Dan saya membuat surat akuan ini dengan kepercayaan bahawa keterangan tersebut di dalamnya adalah benar serta di buat mengikut Akta Akuan Berkanun 1960. Diperbuat dan dengan sebenar-benarnya diakui oleh ) yang tersebut namanya di atas ) iaitu............................................................................. ) ............................................. di................................................................................. ) (Tandatangan Pemohon) Negeri Perak pada............... hb ..................................) Di hadapan saya, ................................................................ (Tandatangan Hakim Mahkamah Seksyen, Majistret atau Pesuruhjaya Sumpah) Salinan Pemohon * Nama : No. Kad Pengenalan : ________________________ Tarikh : _________________ AKUAN PENERIMAAN BORANG PERMOHONAN UNTUK MENYEWA PERUMAHAN RAKYAT BP (PA)1 PIND. 2/09 DI BAWAH PENTADBIRAN LEMBAGA PERUMAHAN DAN HARTANAH PERAK Dengan ini dimaklumkan bahawa borang permohonan tuan/puan telah selamat diterima dan didaftarkan di dalam rekod Perumahan Rakyat. Nombor Daftar Perumahan Rakyat yang Dipohon 1. Pendaftaran ini sah untuk tempoh satu (1) tahun dari tarikh penerimaan borang. Sekiranya tuan/puan tidak dihubungi dalam tempoh ini, maka permohanan tuan/puan adalah terbatal dengan sendirinya. Jika ada sebarang perubahan alamat atau maklumat, sila berhubung dengan pentadbiran ini. Lembaga Perumahan dan Hartanah Perak, Sila rujuk nombor daftar sekiranya untuk Aras G, Bangunan Perak Darul Ridzuan, berurusan dengan pentadbiran ini Jalan Panglima Bukit Gantang Wahab, mengetahui status permohonan anda. 30000 Ipoh, Perak. Tel : 05-2095542 Faks : 05-2530001 ................................................................................Potong di sini........................................................................... Salinan Pejabat * Nama : No. Kad Pengenalan : ________________________ Tarikh : _________________ AKUAN PENERIMAAN BORANG PERMOHONAN UNTUK MENYEWA PERUMAHAN RAKYAT BP (PA)1 PIND. 2/09 DI BAWAH PENTADBIRAN LEMBAGA PERUMAHAN DAN HARTANAH PERAK Dengan ini dimaklumkan bahawa borang permohonan tuan/puan telah selamat diterima dan didaftarkan di dalam rekod Perumahan Rakyat. Nombor Daftar Perumahan Rakyat yang Dipohon 2. Pendaftaran ini sah untuk tempoh satu (1) tahun dari tarikh penerimaan borang. Sekiranya tuan/puan tidak dihubungi dalam tempoh ini, maka permohan tuan/puan adalah terbatal dengan sendirinya. Jika ada sebarang perubahan alamat atau maklumat, sila berhubung dengan pentadbiran ini. Lembaga Perumahan dan Hartanah Perak, Sila rujuk nombor daftar sekiranya untuk Aras G, Bangunan Perak Darul Ridzuan, berurusan dengan pentadbiran ini Jalan Panglima Bukit Gantang Wahab, mengetahui status permohonan anda. 30000 Ipoh, Perak. Tel : 05-2095542 Faks : 05-2530001 *Nota : Hendaklah diisi oleh pemohon. .
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