GRANDEUR ONE APPLICATION NO.

Similar documents
Sub: - Application for Registration for Provisional Allotment of Flat in your Proposed Group Housing MAPSKO CASA BELLA at Sector 82, Gurgaon, Haryana.

APPLICATION FORM. Serviced Apartments

APPLICATION FORM. The most exclusive destination near you

Signature of the Applicant(s) Page 1 of 11. Application Form. Date:..

I/We agree to pay the balance amount towards Consideration of the Floor as per the Payment Plan annexed hereto as Annexure A.

LOGIX INFRADEVELOPERS PVT. LTD.

Reclaim a peaceful state of mind! APPLICATION FORM

Date:.. To, M/s. Purvanchal Construction Works Pvt. Ltd. Purvanchal House, N-4, Sector-18, Noida Distt. Gautam Budh Nagar, (U.P.

PURVANCHAL ROYAL PARK

APPLICATION FORM. To, M/s CAPITAL INFRAPROJECTS PVT. LTD , Vikas Deep Building, Laxmi Nagar District Center, Delhi

APPLICATION FORM FOR ALLOTMENT OF AN APARTMENT

Signature(s)... (Stamp required in case of firm/ company)

Date of Booking: Mode of Booking: Direct/Broker s Name

SHAPATH HEXA. Please affix your photograph. Please affix your photograph. Please affix your photograph

2 Co-applicant. Full name DOB DD MM YYYY. 2.1 Sex. 2.2 S/o, D/o, W/o. Full name. Date of Anniversary DD MM YYYY. 2.3 Marital Status.

RESIDENTIAL APARTMENT AT RIYA MANBHARI GREENS

Name of the First /Sole Applicant. S/D/W/C of Age. Occupation Nationality/Country. Correspondence Address. PAN No

LOGIX CITY DEVELOPERS PRIVATE LIMITED

APPLICATION FOR BOOKING OF SERVICED APARTMENT

Sub. : Application for registration for allotment of flat/dwelling unit in Coban Residences in Sector 99A, Gurgaon, Haryana

APPLICATION FOR BOOKING OF RESIDENTIAL APARTMENT

TRANSFER PROCEDURE / CHECKLIST

GODREJ UNITED PRE-LAUNCH DECLARATION FORM

Mode of Booking: Direct/Broker s Name

APPLICATION FOR BOOKING OF RESIDENTIAL APARTMENT

I / We remit herewith a sum of Rs ( Rs

APPLICATION FOR REGISTRATION FOR PROVISIONAL ALLOTMENT OF UNIT IN SPAZE BOULEVARD SECTOR -47, GURGAON, HARYANA

APPLICATION FOR ALLOTMENT OF FLAT IN RESIDENTIAL COMPLEX ACPL PRAKRITI

Signature of Joint Applicant. Dear Sir/s, SOLE/FIRST APPLICANT Please fill in block letters

APPLICATION FOR ALLOTMENT OF FLAT IN RESIDENTIAL COMPLEX. Laxmisagar, Bhubaneswar SUREKHA WE BUILD. YOU LIVE.

Jaipur Development Authority e-auction :Business Rules Document 2014

APPLICATION FORM. Enhancing lifestyle. New Chandigarh

BOOKING APPLICATION FORM. The Corridors - Phase 2

BOOKING APPLICATION FORM. Serviced Apartments Project

APPLICATION FORM GODREJ ICON SECTOR 89A / 88A, GURGAON JOINT DEVELOPMENT PARTNER

IFCI Infrastructure Development Ltd. (IIDL) IFCI Tower, 61, Nehru Place, New Delhi Phone(s): / , Fax:

FOR BOOKING BY INDIVIDUALS, SOLE/FIRST APPLICANT (Compulsory to fill all the details)

Sub: - Application for Registration of Provisional Allotment of Flat in Group Housing MAPSKO ROYALE VILLE at Sector 82, Gurgaon, Haryana.

high quality urban community living

TENDER FOR SALE OF BPCL OWNED HOUSING COMPLEX AGRA TECHNO- COMMERCIAL BID

APPLICATION FORM 1/2/3/4/5 BHK & PENTHOUSES DEHRADUN DEVELOPING SMART INDIA

Booking Application Form

APPLICATION FORM GODREJ 101

Customer ID No.: Customer Name: Shop / Commercial No.: APPLICATION FORM. offices. retail. homes. Sector-84, Gurgaon

IFCI Infrastructure Development Ltd. (IIDL) IFCI Tower, 61, Nehru Place, New Delhi Phone(s): / , Fax:

No. M-18012/14/2017/SMD/NMCG National Mission for Clean Ganga Ministry of Water Resources, River Development & Ganga Rejuvenation TENDR NOTICE

PENSION FUND REGULATORY AND DEVELOPMENT AUTHORITY B-14/A, Chhatrapati Shivaji Bhawan, Qutab Institutional Area Katwaria Sarai, New Delhi

At Zero distance from Delhi Border (near IGI Airport, New Delhi) Accessible through Dwarka Expressway (under advanced stage of construction)

BOOKING REQUEST FORM

Price List of Independent Floors (W.E.F ) Unit Cost Unit Name

To M/s Raheja Developers Limited Saket New Delhi Dear Sir/s,

THE REAL ESTATE (REGULATION AND DEVELOPMENT) ACT,

Sale of Property under SARFAESI In respect of Germane Teknologies (India) Pvt. Ltd. Tender Document And Terms & Conditions

LIFE INSURANCE CORPORATION OF INDIA MUZAFFARPUR Divisional Office. JEEVAN PRAKASH U.S.PD.MARG, CLUB ROAD MUZAFFARPUR PHONE NO

BPTP LIMITED Application for Allotment by Sale of Residential Flat in The Deck, Park Grandeura, Group Housing Project Sector 82, Faridabad (Haryana)

Formalities by purchaser

NATIONAL INDUSTRIAL PARKS

THE TERMS AND CONDITIONS OF SALE. PROPERTY WILL BE SOLD ON AS IS WHERE IS, AS IS WHAT IS AND WHATEVER THERE IS BASIS. 1. Sri.Radhakrishana Pillai

Tender Document for hiring of office space

ANNEXURE III TERMS & CONDITIONS OF SALE

THE TERMS AND CONDITIONS OF SALE TO BE UPLOADED ON THE WEBSITE OF THE SECURED CREDITOR.

The Authorised Officer (AO) IDBI BANK LIMITED. 1 st Floor, Vasantha Complex No. 43, Imperial Road Opposite to Dailythanthi Cuddalore

DREAM HOME Affordable Flats in Greater Faridabad

The general terms and conditions of last Sale, e- auction held on are as under. The terms and conditions in future sales may be changed.

M/s. Pridhvi Asset Reconstruction & Securitisation Company Ltd. Other terms & Conditions for Sale of Assets of M/s. United Galva Limited LOT -II

TENDER NOTICE FOR DEWATERING, CLEANING &DESILTING OF ARTIFICIAL LAKE PUSHPA GUJRAL SCIENCE CITY KAPURTHALA (PUNJAB)

Delhi Office 3H, Plaza M-6 District Centre Jasola New Delhi

TENDER FOR PURCHASE OF BUILDINGS/BUILT UP FLOOR(S)

Project Address. RERA Regd. No. Photograph. Visiting Card

WEBSITE ADVERTISEMENT

ANSAL HI-TECH TOWNSHIPS LTD Application for Allotment by Sale of a Unit in A-4 Group housing

: Lease Accommodation for Office Space. Tender Ref. No. : PHL/ER/HR&A/OFF/2017 dated 24/02/2017

TENDER FOR LEASING OUT SHEDS AND OPEN SPACE AT UDYOG NAGAR, INDUSTRIAL ESTATE, NAINI ALLAHABAD

RAHEJA THE GREEN CITY APPLICATION FORM

Homtech Awas Yojna DMD HOMTECH. Dream come true RUPA Lakhs* First time in Central Noida

1.Mrs. J.Sankari, (Borrower) W/o.S.Janagarajan, No.3, 7 th Cross Street, Rajiv Gandhi Nagar, Dharapadavedu, Katpadi Taluk, Vellore

By Regd Post & Courier 21/6, Mosque Colony, 5 th Street, Flat No.B-3, Second Floor,

Notice of 30 days for sale of immovable secured assets under Rule 8 of the Security Interest (Enforcement) Rules, 2002.

1 Office Space on Lease at Guwahati. Ref. No. Casf Date : Bharat Petroleum Corporation Limited (A Government of India Enterprise)

TERMS & CONDITIONS FOR SALE OF COAL MILL REJECTS OF TATA POWER LIMITED

INDEPENDENT FLOORS Vatika Limited. Dear Sirs,

, Lord Sinha Road, Kolkata

APPLICATION FORM WTC SIGNATURE

Details of are as below : 1. The bid will be submitted in two parts, Technical Bid (Un-priced Bid) and Commercial Bid (Priced Bid).

Sub: Notice of 30 days for sale of immovable secured assets under Rule 8 of the Security Interest (Enforcement) Rules, 2002.

Bharat Petroleum Corporation Limited (A Government of India Enterprise) LEASING OF OFFICE SPACE AT NEW DELHI

STOCK HOLDING CORPORATION OF INDIA LTD.

An ISO 9001 : 2008 Cer fied Co-op. Housing Society

Date of Birth Nationality. Correspondence Address. Pin. Contact No.: Office Residence Mobile. ID Aadhar No. PAN GST No.

GRAND AJNARA HERITAGE SEC-74 NOIDA

TENDER DOCUMENT FOR SALE OF MORTGAGED/HYPOTHECATED ASSETS FOR SECURING THE FINANCIAL ASSISTANCE AVAILED BY

Re Property : Plus Carpark Number* Serial No. :

Dates for Inspection of property: & (From 11:00am to 02:00 pm)

Sr.Divisional Manager LIFE INSURANCE CORPORATION OF INDIA Divisional Office :Jeevan Prakash, Nagpur Road,Madan Mahal,JABALPUR

Tender. For. Consultancy Services for Auditorium interior works. All India Institute of Medical Sciences, Patna

Branch Office: Mookherjee House, PhoneNo / st Floor, 17 Brabourne Road, Fax no

Telephone: Fax :

SHALIMAR BAGH BRANCH 26/28, DDA Commercial Complex, BQ Block NEW DELHI Pin Ph Nos ;

1. Name and address of the Borrower/ Co obligant/guarantor

APPLICATION FORM FOR ALLOTMENT BY SALE

Transcription:

GRANDEUR ONE V P SPACES Private Limited 906, 9 th Floor, ILD Trade Centre, Sohna Road, Gurgaon - 122001. APPLICATION FOR BOOKING / PROVISIONAL ALLOTMENT OF COMMERCIAL UNITS / RETAIL UNITS / MANAGED HOMES / SERVICE APARTMENT IN GRANDEUR ONE, SECTOR-56, BHIWADI, RAJASTHAN. DATE APPLICATION NO. Dear Sir, I/We request for provisional allotment of a COMMERCIAL UNITS / RETAIL UNIT(S) / MANAGED HOMES / SERVICE APARTMENTS IN GRANDEUR ONE of land at Sector- 56, Biwadi, Rajasthan. I/We undertake that we understand English language and / or this document has been read over to me after due consultation with my legal counsel and understand the legal consequences of signing of this document. I/We agree and note that the acceptance of this application for booking / provisional registration and final allotment of the COMMERCIAL UNITS / RETAIL UNITS / MANAGED HOMES / SERVICE APARTMENTS is entirely at the sole discretion of the Company. I/We have clearly understood that this application does not constitute agreement to sell notwithstanding the fact that the Company may have issued a receipt in acknowledgement of the money tendered with this application. The Company reserves every right to accept or reject any proposal without assigning any reason(s) and without incurring/carrying any liability towards cost/damage/interest etc., except the amount of registration or thereafter shall be refunded to the applicants without any interest thereon. I/We make this application for registration with full knowledge that the company has obtained all necessary approvals from all competent authorities and is in the process of obtaining/procuring building plan for the setting up of project at Sector-56, Bhiwadi Rajasthan from the competent authority(ies). I/we remit herewith a sum of Rs. /- (Rupees only) by Bank Draft / Pay Order / Cheque / RTGS No. dated drawn on Bank towards booking amount. I/We have perused the "Schedule of Payment" and

agree to pay further installments of the Basic Schedule of Payment charges as stipulated/called upon by the Company and / or as contained in this application form. I/We further understand that the expression "Allotment" of the residential space as and when made by the Company shall always mean provisional allotment. I/WE further agreed that it is only after issuance of Allotment Letter by the company and further the signing and executing the BUILDER & BUYER AGREEMENT on the Company s prescribed format agreeing and abiding by the terms & conditions laid down therein, that the allotment shall become final on both the parties. If, however, I/WE fail to execute and return the BUILDER & BUYER AGREEMENT within the period of (30) thirty days from the date of its receipt of the agreement after being dispatch by the company, then It shall be the sole discretion of the company to treat this application as cancelled and the application money shall stand forfeited. I/we agree that the BUILDER & BUYER AGREEMENT shall not be binding upon Company until executed by the authorised person of the company. In the event of the Company accepting my/our application to allot COMMERCIAL UNITS / RETAIL UNITS / MANAGED HOMES / SERVICE APARTMENTS, I/we further agree to pay further installments of the sale price and all other dues, charges, taxes, etc., as per the payment schedule prescribed by the Company. I/WE also further undertake to sign and execute as and when required, the Allotment letter containing terms and conditions of allotment, BUILDER & BUYER AGREEMENT and other necessary documents in the prescribed format of the Company. I/WE have understood and accept that 10 % (ten) of the total sales price as per the BUILDER & BUYER AGREEMENT shall constitute the earnest money and are fully aware of the consequences on account of non-payment of installments within stipulated time. I / WE have understood and agreed that I / WE shall not be entitled to take possession of the COMMERCIAL UNITS / RETAIL UNITS / MANAGED HOMES / SERVICE APARTMENTS without the payment of all dues charges including registration charges and stamp duty charges. I/WE shall have understood and agreed that the company shall have the full and sole authority and power to amend the terms and conditions of the BUILDER & BUYER AGREEMENT and MAINTENANCE AGREEMENT as and when it deems fit. I / WE agree to pay Basic Sale Price of COMMERCIAL UNITS / RETAIL UNITS / MANAGED HOMES / SERVICE APARTMENTS and other charges like EDC (External

Development Charges), IDC (Infrastructure Development Charges), Car Parking, IFMSC (Interest Free Maintenance Security Charges) Club Membership Charges, Power Back-up per KVA, PLC (Preferential Location Charges) Park Facing, PLC (Preferential Location Charges) Highway Facing, Electricity Connection Charges, Water Connection Charges, Contingency Charges and other charges levied from time to time by the company. I/WE further understood and agreed that in case of any difference and / or between the company and me/us, the same shall be referred to the arbitrator of a sole arbitrator to be appointed by the Chairman or Board of Directors of the Company after passing a necessary resolution. The award of the arbitrator shall be final and binding on the parties. It is further agreed and understood between the parties that only Courts/Tribunals/Quasi-Judicial Authorities of Bhiwadi, Rajasthan shall have exclusive Jurisdiction to entertain any dispute arising out of this application. The venue of the Arbitration shall be at Bhiwadi Rajasthan. I/WE give consent to the terms and conditions as detailed in Schedule A annexed herewith, which has been fully read and understood by me/us. I/We agree to abide by the terms and conditions of this application including those relating to payment of Basic Sale Price and other changes, forfeiture of provisional registration charges and all of the provisions as laid down herein. I/WE being partner(s) under partnership firm duly registered under the Indian Partnership Act, 1932 under the name & Style of vide Registration No through a resolution dated duly signed and after fulfilling all legal formalities by all Partners is furnished herewith.) I/WE being authorized signatory of the company registered under the provisions of Companies Act, 1956 or Under the provisions of Companies Act, 2013 or under any other enactment recognized under Indian Law(s) under the name & Style of vide Registration No through a resolution dated duly signed and after fulfilling all legal formalities by Board Of Directors or other valid constituted body under any other law other then Companies Act, 1956 or

Companies Act, 2013 is furnished herewith. (Certified True Copy of the resolution signed by the Chairman/Director is furnished herewith.) I/WE further agreed and confirm that the company is not bound by any information expressly or impliedly provided in the brochure, advertisement, hoardings, pamphlets and any form likewise. I/WE here make the declaration that signing of this document shall mean the acceptance of the offer with terms and conditions of the company. SOLE/ FIRST APPLICANT (All fields are compulsory) 1) Mr. /Ms. /Mrs. 2) S/W/D of 3) Age Date of Birth 4) Guardian Name (in case of Minor) 5) Nationality 6) Occupation: Service ( ) Professional ( ) Business ( ) Student ( ) Housewife ( ) Any other ( ) 7) Residential Status: Resident ( ) Non Resident ( ) Foreign National of Indian Origin ( ) Others ( ) 8) Mailing Address (Shall not be the address of communication) Telephone (Res.) Mobile E-Mail

9) Permanent Address (Shall be the address of communication) Telephone (Res.) Mobile E-Mail 10) PAN No (Attach Form 49A or 60 or 61 as the case may be, if PAN not available) SECOND APPLICANT (All fields are compulsory) 1) Mr. /Ms. /Mrs. 2) S/W/D of 3) Age Date of Birth 4) Guardian Name (in case of Minor) 5) Nationality 6) Occupation: Service ( ) Professional ( ) Business ( ) Student ( ) Housewife ( ) Any other ( ) 7) Residential Status: Resident ( ) Non Resident ( ) Foreign National of Indian Origin ( ) Others ( ) 8) Mailing Address (Shall not be the address of communication)

Telephone (Res.) Mobile E-Mail 9) Permanent Address (Shall be the address of communication) Telephone (Res.) Mobile E-Mail 10) PAN No (Attach Form 49A or 60 or 61 as the case may be, if PAN not available) DETAILS OF PRICING: 1. Basic Sale Price @ Rs..... (per Sq.Ft.) 2. Super Area Payment Plan opted: Plan - A (Down Payment Plan) ( ) Plan - B (Flexi payment Plan) ( ) Plan C (Construction Linked Plan) ( ) 3. Property Applied For: (i) Retail ( ) (ii) Office ( ) (iii) Managed Home(s) ( ) (iv) Hotel ( ) (v) Service ( ) 4. Car Parking is optional 5. Mode of Booking: Direct: ( ) Broker: ( ) 6. Broker Name with Address and Rubber Stamp Broker Details:

7. Payment Plans: - A) DOWN PAYMENT PLAN (12% Assured Return) PAYMENT STAGE B.S.P. IN % OTHER SERVICES ASSURED RETURN TILL POSSESSION At the time of 10% + Service Tax booking Within 45 days of 85% + Service Tax Car Parking (Optional) 12% p.a. on 95% booking On offer of Possession 5 % + Service Tax PLC + Other Charges + Power Backup + Club Membership + IFMS payment B) FLEXI PAYMENT PLAN PAYMENT STAGE B.S.P. IN % OTHER SERVICES ASSURED RETURN TILL POSSESSION At the time of 10% + Service Tax booking Within 45 days of booking Within 18 months of Booking or Completion of Structure On offer of Possession 40% + Service Tax Car Parking (Optional) 25% + Service Tax PLC + 50 % of Other Charges + EDC/IDC 25% + Service Tax 50 % of Other Charges + Power Backup + Club Membership + IFMS 12% p.a. on 50% payment C) CONSTRUCTION LINKED PLAN PAYMENT STAGE B.S.P. IN % OTHER SERVICES ASSURED RETURN TILL POSSESSION At the time of 10 % + Service Tax Not Applicable booking Within 45 days of 20 % + Service Tax Car Parking

Booking On Start of Foundation On Start of Ground Floor Slab On Start of Fifth Floor Slab On Start of Tenth Floor Slab On Start of Fourteenth Floor Slab On Start of Flooring Floor Slab On Offer of Possession (Optional) 10 % + Service Tax Club Membership 10 % + Service Tax PLC 10 % + Service Tax EDC/IDC 10 % + Service Tax 10 % + Service Tax 10 % + Service Tax Power Back Up 10 % + Service Tax IFMS + Stamp Duty etc. NOTE: 1. The Basic price is escalation free, but subject to revision / withdrawal without notice at company s sole discretion. That the present prices are effective w.e.f 13.04.2014. The prices indicative above are subject to revision from time to time at the sole discretion of the company. That the Unit Area is tentative and subject to change. 2. Prices and other terms and conditions herein are tentative and given only to acquaint the applicant and are not exhaustive. For terms and conditions binding upon the parties please refer to Application form and Buyer & Builder Agreement. 3. Cheque(s)/Demand Draft(s) to be made in favour of "V P Spaces Private Limited." Payable at Delhi. All payments shall be subject to their actual realization in the above mentioned account. 4. Allotment to NRIs/PIOs shall be subject to Exchange Control Laws of India and any compliance with the provisions of Foreign Exchange Management Act 1999 (FEMA) or any other statutory enactments shall be the exclusive liability of the applicant. The date of credit into the above account shall be deemed to be the date of the exchange rates prevailing as on such date shall be applicable for payments made in foreign currency. In case, the cheque comprising registration amount is dishonoured due to any reason the Company reserves the right to cancel the registration without giving any notice to the applicant(s). All amounts received from Applicant(s) other than resident Indian shall be from NRE / NRO / Foreign Currency Account only. 5. Incomplete forms shall be rejected without any consideration and relief. 6. Any other facility, if provided shall be charged Extra. DECLARATION

I/We the above applicant(s) do hereby declare that the above particulars / information given by me / us for registration for provisional allotment of a COMMERCIAL UNITS / RETAIL UNITS / MANAGED HOMES / SERVICE APARTMENTS are true and correct and nothing has been concealed there from. In case of any false or misleading information provided by me/us, the company shall be entitled to cancel the allotment with the right to forfeit the amount given by the applicant. SIGNATURES FIRST / SOLE APPLICANT SECOND APPLICANT Place Date Documents to be enclosed: IN CASE OF INDIVIDUALS / HUF Personal particulars of Applicant 2 Passport size photographs of each applicant Self attested copy(ies) of Identity proof Self attested copy(ies) of Residence proof of the Applicant Self attested copy(ies) of Pan Card of Individual / HUF IN CASE OF PROPRIETORSHIP/ PARTNERSHIP FIRM Personal Particulars 2 Passport size photographs of Proprietor / each partner Letter of proprietorship / Registered partnership deed / notarized partnership

Private Limited & Limited Company / LLP deed with appropriate stamp duty Certified true copy of the board's/partners' resolution' / authorization letter for purchase of COMMERCIAL UNITS / RETAIL UNITS / MANAGED HOMES / SERVICE APARTMENTS in case of partnership Self attested copy(ies) of Identity proof(s) Self attested copy(ies) of Residence proof(s) Self attested copy(ies) of Pan Card List of Partners Personal Particulars 2 Passport size photographs of authorized person of the company / LLP Self attested copy(ies) of Identity proof(s) of authorized person Self attested copy(ies) of Address proof(s) of company / LLP Self attested copy(ies) of Pan Card of the company / LLP MOA and AOA duly signed by the Directo/CS/KMP of the company and Registration Certificate and LLP Agreement under LLP Act Certified true copy of Board s Resolution authorizing the signatory of the application Form to purchase

COMMERCIAL UNITS / RETAIL UNITS / MANAGED HOMES / SERVICE APARTMENTS in case of partnership List of Directors duly signed by the Director/CS/KMP/List of Partners under LLP Act, duly signed by all the partners. Self-attested copy of Form 32 along with Challan in case of Change of Directors. IN CASE OF NRI / OCI / PIO 2 Passport Size photographs of each Applicant Self-Attested copy of Address Proof of each applicant Self-Attested copy of Passport Status or Proof of NRI / OCI / PIO Original / Registered GPA or Certified Copy of the same from appropriate authority Letter from the Executant that the GPA is valid till date. In case of Telegraphic transfer, a copy of Debit Advice from the remitting Bank. In case of Demand Draft, the confirmation from the banker that the DD has been prepared from the Proceeds of NRE/NRO account of the Applicant

In case of Cheque, all payments to be received from the NRE/NRO/FCNR account of the Applicant only.

FOR OFFICE USE ONLY DEALING OFFICER DATE NAME SIGNATURE 1. Application : ACCEPTED / REJECTED 2. BSP Sale Price @ Rs per Sq. Ft. Super Area Sq. Ft. approx. Total Basic Cost excluding all Charges Type Unit no. Floor 3. Retail Unit(s) Ground Floor First Floor 4. Office Space Second Floor & Above 5. Service Apartment Second Floor & Above A) SELF SERVICED B) MANAGED POOL 6. Car Parking Rs. 7. Preferential Location Charges, as applicable a) Park Facing @ 3 % BSP b) Highway Facing @ 5 % BSP 8. Payment Plan Opted for: A) Down Payment Plan B) Flexi Payment Plan C) Construction Linked Plan

9. Payment received Vide Cheque / DD / Pay Order No. Dated out of NRE/NRO/FC/SB/CUR 10. Provisional booking receipt no. dated 11. BOOKING: A) DIRECT B) BROKER 12. Broker s Name and Address, stamp with Signature Remarks DATE PLACE DATE