Name of Applicant *:
Father/Husband/ Guardian's Name *:
Correspondence Address *:
City/ Distt. *:
State*:
Pin Code*:
Phone No.*:
Plot Size *:
   100 to 125 Yards       150 to 200 Yards
   200 to 250 Yards                   Any  Size
   
Flat Size *:
500 to 900 Sq. Feet 900 to 1500 Sq. Feet
                 Any  Size  
   
Shop Size *:
200 to 500 Sq. Feet 500 to 1000 Sq. Feet
                 Any  Size  
 
Detail of financial required:*
Detail of Booking AMT.:*

DD/PAY ORDER NO.

DATED:

BANK NAME:

AMOUNT:

I / We agree to abide by the terms and conditions a said out by the company allotment of the aforesaid plot/ shop agree to sign the Allotment Letter / Purchase Agreement on the company's prescribed form.

I/ We agree to pay in accordance with the mode of payment agreed as per the terms of the company.


SIGNATURE OF APPLICANT

Dated: