JUSCO

Jamshedpur Utilities & Services Company Limited

G.M. (J.T.S.)
Jamshedpur Utilities & Services Company Limited
Jamshedpur

Thro’s Head of the Department

Dear Sir,

I shall be glad if you please arrange to undertake the following addition / modification to my
house for which I am agreeable to pay additional rent as per the Company’s rules.

1. Location of residential house No.& type………………………………………………………………………………

Road No………………………………………………………………………………..

Area…………………………………………………………………………………..

2. Particular of proposed additional/modification…………………………………………………………………….

(List to be given priority-wise if more than one)…………………………………………………………………..

…………………………………………………………………..

3. Name of the applicant………………………………………………………………………………………………………….

4. P.No……………………………..Department…………………………………………………………………………………..

5. Designation……………………………………………… Contact No. (Ph. No.)(Mandatory) …………………………………………………

6. Grade of Applicant (Rs.)………………………………………………..

7.Present Basic Pay (Rs.)………………………………………………

8. Date of Application………………………………………………………

9. Declaration: Following Jobs have already been carried out/in progress/sanctioned for which
Rent of the house is yet to be recovered.

1)………………………………………………………………………………………………………………….

2)…………………………………………………………………………………………………………………

3)…………………………………………………………………………………………………………………

10. Fan hook is existing/ not existing

Signature of the Applicant.

Date

-----------------------------------------------------------------------------------------------------------------------------------
Date:

To be filled in by the applicant:

Received from Sri/Smt………………………………………………………………………………………………………………….
P.No………………………………..Dept…………………………………………………………………………………………………….
An application for…………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………….

Office of the G.M. ( J.T.S.)