Application form for the acquisition of a house or a serviced plot of land

I. Civil status of the applicant

^*Name

^*First name

Genre

Male

Female

Maiden name

^*Date of birth

^*Place of birth

^*Nationality

Family status

Single

Married

Concubinage

Divorced

Widower

^*Identity card number

Nature of the identity card

Issued on

Issued by

^*Expiry date

^*Number of dependents

^*Address

^*City

^*Office phone

^*Home phone number

^*Email

II. Marital status of the spouse

Name

First name

Maiden name

Date of birth

Place of birth

Nationality

III. Monthly income

^*Job held since:

^*Employer

^*Applicant Income

^*Spousal income

Type de contratNothing to add

Fixed-term contract

Open-ended contract

3. Product requested

1. Housing and plot

2. You are requesting accommodation of the following type :

3. Product requested

4. Indicate the area of the parcel :

5. How would you like to finance the purchase of the house/plot :

Certified cheque

Bank transfer

Real estate credit

Cash

6. You wish to have access to the housing/parcel within a time limit :

Immediate (less than 5 months)

Medium term (between 5 and 12 months)

Long term (more than 1 year)

7. You wish to acquire a house or a serviced plot of land located in :

Specify

V. Documents to be provided

Colored identification photo (1)

Colored identification photo (2)

A copy of the identity document of the applicant and his/her spouse/partner

Marriage certificate/certificate of cohabitation, for all persons living as a couple (legalized copy)

A birth certificate of the applicant, his wife or partner and dependent children (legalized copy)

Vos trois derniers bulletins de salaire du demandeurYour last three pay slips

Certificate of non-indebtedness

A certificate of bank credit - A bank statement for the last three months

Persons financing the purchase of the home or parcel by certified check,bank transfer or cash will only be required to provide a copy of their identification.

APPLICATION FEE : 70 000 CFA FRANCS / 107 € / 128 $

To be paid by the applicant for the constitution of the file, which will be examined and rated by the technical committee in charge of the selection of the files. Payments can only be made by cash or certified cheques.

ANY INCOMPLETE FILE WILL BE REJECTED

IMPORTANT RECOMMENDATIONS

FILL IN AS MUCH INFORMATION AS POSSIBLE AND WITH SINCERITY.

Please verify your information before submitting the form. Click on Send to validate or on Cancel to go back.

I. Civil status of the applicant

Name:

First name:

Genre:

Follow your request:

Date of birth:

Lieu de naissance :Place of birth

Nationality:

Family status:

Identity card number:

Nature of the identity card:

Issued on:

Issued by:

Expiry date:

Number of dependents:

Address:

City:

Office phone:

Home phone number:

Email:

II. Marital status of the spouse

Name:

First name:

Maiden name:

Date of birth:

Place of birth:

Nationality:

III. Monthly income

Job held:

Employer:

Applicant Income:

Spousal income:

Type of contract:

3. Product requested

3. Product requested:

Type of housing:

Serviced plot of land requested:

Surface area of the parcel:

Type of funding:

Time to access housing:

Location of the accommodation:

Other Location:

Pay

obligatoire1 * obligatoire2

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