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I ~ HI-TECH lEI ~ITATES PIIOMOlBIS M LTD. HI-TECH ESTATES at PRO Regd. No. : 15-05577/98-99 111, Sa heed Nagar, Bhubaneswar-751 007 OTERS (P) LTD. 133 No.: .•.•.••••.•••• To, Fill the form in Block Letters The Executive Director HI-TECH ESTATES 8t PROMOTERS (P) LTD. Sir, I am interested to purchase a flat I house to be constructed at Hi-Tech Brundaban Projectat Mouza- Batagaon, Puri. I also agree with your Terms & Conditions. APPLICATION FORM M.R.No.( ) Block NO.( ) Flat No. ( ) Super BuiltupArea :( ) '-;:::=========:::::: Name:(~~========~~ __ ~~ __ ~~========~ __ ~========~~)Age~:~(======~) Date of Birth ( ) Marriage Date (If married) ( ) Caste( ) Occupation ( ) Father's/Husband's Name( ) Address:TemporaryAt/Po ( ) ( ) PS :( ) Dist :( ) Pin ( ) Tel ( ) E-mail: ( ) rpe_r_m_a_ne_n_t_At/_P_O~(~==============================~ __ ~==================================~) ( ) PS :( ) Dist: ( ) Pin ( ) Tel ( ) Nominee :(~ ~) Source of Finance: Bank Finance /SELF Monthly payment I Self as per Bank Date: Place: N.B.:All type of payment should be made by Cheque/D.O. in favour of HI-TECH ESTATES & PROMOTERS PVT. LTD., payable at Bhubaneswar Signature of the Customer INTRODUCED BY: VERIFIEDBY: SIGNATUREOFTHEACCOUNTANT M.R. No. ( ) BOOKING AMOUNT. ( ) ~ CHQ/DD NO-:-.-;(==========================~) DRAWN ON ( ) ~ TOTALCOST:( ) SCHEME( ) ~ INST.PATIERNRS.( ) MONTH ( ) ~ BOOKING DATE: ( ) ALLOTMENTDATE: ('- ~) o u,
