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APPLICATION FORM
SAMPLE
Application No._______________
ARVIND AND SMART VALUE HOMES LLP.
1008/1009,10th floor,
Venus Atlantis Corporate Park,
Near Reliance Petrol Pump, Anand Nagar Road
Prahlad Nagar,
Ahmedabad – 380054
Dear Sir,
I/We request/offer that I/we may be registered for provisional allotment of a Residential Apartment/Flat (as
mentioned in this Application Form) in the Complex “SHUBGRIHA” situated at village Moti Bhoyan, Taluka
Kalol Dist – Gandhinager Pin Code 382721, bearing Consolidated Block No. 1263 (part) (hereinafter
referred to as “said Land”) to be developed by Arvind and Smart Value Homes LLP. (hereinafter referred to as
“ASVHL”).
INSTRUCTIONS: 1. Please fill up the form with black ink ball point pen only • 2. Please fill in the form in CAPITAL letters • 3. Please fill one letter in one box
I/We remit herewith a sum of Rs. 25,000/- (Rupees Twenty Five Thousand Only) drawn on
I D B I
Demand Draft No.
Bank,
1 2 3 4 5 6
Dated
Date
Month
Year
0 8
0 1
2 0 1 2
in favour of
“ARVIND & SMART VALUE HOMES PROJECT RECEIPT ACCOUNT” payable at Ahmedabad as
Application Money.
(Please fill in relevant portions of this APPLICATION FORM for Individual/Joint or Other Entity. Strike out
portions that are not applicable and deposit this APPLICATION FORM in full.)
[ SIGNATURE ]
Signature of Sole/First Applicant
Signature of Joint/Co-applicant
1
INSTRUCTIONS: 1. Please fill up the form with black ink ball point pen only • 2. Please fill in the form in CAPITAL letters • 3. Please fill one letter in one box
Please sign
My/our particulars are given below for your reference and record.
across the
SOLE/ FIRST APPLICANT
photograph
TURE
SIGNA
FULL NAME, in CAPITAL Letters (In the order of First, Middle and Last Name, Leaving a space between words)
Name:
R A M E S H
D I
L I P
P A T E L
FULL NAME, in CAPITAL Letters (In the order of First, Middle and Last Name, Leaving a space between words)
Son/Wife/Daughter of:
D I
L I P
K U M A R
P A T E L
FULL NAME, in CAPITAL Letters (In the order of First, Middle and Last Name, Leaving a space between words)
Guardian’s Name (if minor):
Date of Birth:
Gender: Male
Nationality:
Date
Month
Year
0 4
0 6
1 9 7 6
Female
Marital Status: Married
Other
I N D I A N
Occupation: P R I V A T E
S E R V I C E
A B C D E 1 2 3 4 5
IT PAN :
Single
Residential Status: Resident
(If any)
Non-Resident
Foreign National of Indian Origin
OCB others
(Please leave a space between each part of the address)
Permanent Address: A - 1 0 0
B U N G L OW
U DY O G
N A G A R
V A S T R A P U R
City
A HM E D A B A D
Phone: Home
State
GU J AR AT
0 7 9 2 3 1 2 5 9 6 8
Mobile
9 8 0 0 0
Email:
r a m e s h @ g m a i
Work
Pin Code
3 8 0 0 0 1
0 7 9 3 2 1 2 3 4 5 6
1 2 3 4 5
l . c o m
I wish to receive all communications including demand letters from ASVHL via e-mail as mentioned herinabove.
Correspondence Address (for Sole/ First Applicant):
(Tick here if same as permanent address)
City
State
Pin Code
Phone: Home
Current Residence: Owned
Profession/Job Title: E X
Work
Rented
Employment Type: Self Employed
Salaried
E C U T I V E
[ SIGNATURE ]
Signature of Sole/First Applicant
Signature of Joint/Co-applicant
2
INSTRUCTIONS: 1. Please fill up the form with black ink ball point pen only • 2. Please fill in the form in CAPITAL letters • 3. Please fill one letter in one box
Please sign
across the
photograph
JOINT / SECOND APPLICANT
FULL NAME, in CAPITAL Letters (In the order of First, Middle and Last Name, Leaving a space between words)
Name:
Son/Wife/Daughter of:
Relation with the First Applicant:
Guardian’s Name (if minor):
Date
Month
Year
Date of Birth:
Gender: Male
Female
Marital Status: Married
Single
Other
Nationality:
Occupation:
(If any)
IT PAN :
Residential Status: Resident
Non-Resident
Foreign National of Indian Origin
OCB others
(Please leave a space between each part of the address)
Permanent Address:
City
State
Pin Code
Phone: Home
Work
Mobile
Email:
I wish to receive all communications including demand letters from ASVHL via e-mail as mentioned herinabove.
(Tick here if same as permanent address)
Correspondence Address (for Sole/ First Applicant):
City
State
Pin Code
Phone: Home
Work
Mobile
Current Residence: Owned
Rented
Employment Type: Self Employed
Salaried
Profession/Job Title:
[ SIGNATURE ]
Signature of Sole/First Applicant
Signature of Joint/Co-applicant
3
INSTRUCTIONS: 1. Please fill up the form with black ink ball point pen only • 2. Please fill in the form in CAPITAL letters • 3. Please fill one letter in one box
COMPANY AS AN APPLICANT
Name of Company:
Date of Incorporation:
D D
M M
Y
Y Y Y
(Mandatory)
Company IT PAN:
(Please leave a space between each part of the address)
Registered Address:
City
State
Pin Code
(Please leave a space between each part of the address)
Correspondence Address:
City
State
Pin Code
Name of the contact person:
Phone: Home
Work
Mobile
Email:
[ SIGNATURE ]
Signature of Sole/First Applicant
Signature of Joint/Co-applicant
4
INSTRUCTIONS: 1. Please fill up the form with black ink ball point pen only • 2. Please fill in the form in CAPITAL letters • 3. Please fill one letter in one box
*PROVISIONAL REGISTRATION FOR THE APARTMENT / FLAT:
Unit Type
Carpet Area
Price
(i)
1 Room Kitchen (All Floors)
293 Sq.Ft.
Rs.7,92,300
(ii)
1 Bedroom Hall Kitchen (1st - 4th Floor)
372 Sq.Ft.
Rs.10,03,200
(iii)
1 Bedroom Hall Kitchen Ground Floor
384 Sq.Ft.
Rs.10,37,400
(iv)
1.5 Bedroom Hall Kitchen (1st - 4th Floor)
446 Sq.Ft.
Rs.12,04,600
(v)
1.5 Bedroom Hall Kitchen Ground Floor
457 Sq.Ft.
Rs.12,33,100
(Deposits and other charges as mentioned in Annexure “A”)
1 RK
1 BHK
1.5 BHK
(Please tick applicable flat type. If no option is chosen, 1 Bedroom Hall Kitchen option would apply)
*Registration of only one apartment /Flat per application permitted.
Tick to indicate preference for Ground Floor.
(Note: Incase Ground Floor unit is not allotted, unit on any other floor may be allotted subject to random selection.)
PAYMENT
(i)
Self Finance
Rs.
3 0 0 0 0 0
(ii)
Loan Required
Rs.
7 0 3 2 0 0
RELATIONSHIP WITH THE DESIGNATED PARTNER/S OF ASVHL OR THE ENTITY/S IN WHICH
SUCH DIRECTOR/S IS/ARE INTERESTED
Whether the Applicant/s is Director or related to any of the
director/s of ASVHL?
Yes
No
(Tick as applicable)
If yes, then kindly provide details in Annexure “B”
*Nomination by:
1.
First Applicant
Name of Nominee
2.
Second Applicant
Name of Nominee
*The nomination will be allowed only once till the formation of the Society/Condominium [as the case may be].
Bank account details for refund (in case of non allotment of flat/apartment)
Name of account holder: R A M E S H
D I
L I P
P A T E L
Bank account number: 1 2 3 4 5 6 7 8 9 0 0
Bank name: B A N K
Branch location:
City
O F
B A R O D A
V A S T R A P UR
AHME DA B AD
MICR Code: 0 0 0 0 0 0 1 2 3
State
G U J A R A T
IFSC Code: A B C D 0 0 0 0 0 0 0
[ SIGNATURE ]
Signature of Sole/First Applicant
Signature of Joint/Co-applicant
5
INSTRUCTIONS: 1. Please fill up the form with black ink ball point pen only • 2. Please fill in the form in CAPITAL letters • 3. Please fill one letter in one box
APPLICANT WHETHER PIO / NRI (Tick as applicable)
Whether the Applicant is NRI?
Yes
No
Whether the Co -Applicant is NRI ?
Yes
No
I / We hereby declare that and confirm that I am/ We are a Non
Resident Indian and I /We shall comply with all the statutory
compliances as required from time to time under applicable laws/
rules and ASVHL shall not be liable for the same in any manner
whatsoever.
Signature of the Applicant
Whether the Applicant is PIO?
Yes
No
Whether the Co -Applicant is PIO ?
Yes
No
I / We hereby declare that and confirm that I am/ We are a Person
of Indian Origin and I / We shall comply with all the statutory
compliances as required from time to time under applicable laws/
rules and ASVHL shall not be liable for the same in any manner
whatsoever.
Signature of the Applicant
[ SIGNATURE ]
Signature of Sole/First Applicant
Signature of Joint/Co-applicant
6
Signature of Sole/First Applicant
Signature of Joint/Co-applicant
7
1.5 BHK
Carpet Area (CA): 446 Sq.Ft.
1.5 BHK Ground Floor
Carpet Area (CA): 457 Sq. Ft.
[ SIGNATURE ]
Signature of Sole/First Applicant
Signature of Joint/Co-applicant
23
PLEASE SUBMIT THE FILLED UP APPLICATION FORM AT ANY OF THE FOLLOWING LOCATIONS
IDBI Bank Branches
Branch Timings: Mon-Fri 10:00 AM to 4:00 PM, Sat 10:00 AM to 1:00 PM
Location
Address
Satellite
1,2 - Sigma Icon, Opp. Medilink Hospital, Nr. Shyamal Cross Road,
132 Ft. Ring Road, Ahmedabad - 380015
Bodakdev
23-25, Rudra Square, Nr. Judges Bungalow, Bodakdev, Vastrapur,
Ahmedabad - 380015
Gandhinagar
Super Mall - Infocity, Near GH "0" Circle, Gandhinagar – 382009
Maninagar
Tulsi Complex,Opp. Municipal Swimming Pool, Pushpkunj Circle, Kankaria
Maninagar Road, Maninagar – 380008
Ghatlodia
Aishwarya Complex, Yash Kunj Society, Prabhat Chowk, Ghatlodia,
Ahmedabad – 380061
Sabarmati
Sabarmati Branch, Shukan Mall, Nr. Visat Petrol Pump, Sabarmati Gandhinagar
Highway, Ahmedabad – 380005
CG Road
IDBI Complex, Lal Bungalows, Off CG Road, Ahmedabad – 380006
Paladi
Hitek Building, Opp. Museum Paladi, Ahmedabad – 380007
Prahladnagar
Shop No. 02, Campus Corner, 2100 Ft. Road, Opp. Auda Prahaladnagar Garden,
Prahlandnagar, Ahmedabad – 380015
Shahibaug
Advance Plaza Opp: Swaminarayan Temple Shahibaug Ahmedabad – 380006
Memnagar
Krishna Avenue Subash Circle Memnagar Ahmedabad – 380052
Bapunagar
Office No. 219, Shayona Arcade, Opp. Dinesh Chambers, Main Road, Bapunagar,
Ahmedabad – 380024
24
ACKNOWLEDGEMENT SLIP
SAMPLE
Received Application No.: ____________________________
Name of the Sole /First Applicant:
FULL NAME, in CAPITAL Letters
Mr./Mrs./Ms./Master
R A M E S H
D I
Demand Draft /Pay Order : 1 2 3 4 5 6
Drawn on
D D
6
Date: 1
L I P
P A T E L
Dated:
D D
0
8
M
0 M
1
Y Y
Y
2
0 Y
1 2
I D B I
M
0 M
1
Bank
Y Y
2Y 0
1 Y2
IDBI
SIGNATURE &
SEAL
Signature and Stamp of Authorised Official
25
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