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Application Form

The document is an application form for a real estate development company. It requests personal information from applicants such as name, age, address, contact details, occupation, and payment details. It also lists the available housing categories and payment plans.

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joshuafemi1998
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30 views

Application Form

The document is an application form for a real estate development company. It requests personal information from applicants such as name, age, address, contact details, occupation, and payment details. It also lists the available housing categories and payment plans.

Uploaded by

joshuafemi1998
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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HAVILAH CONCEPT

Shema Filling Station, Abuja


Email: [email protected]

TEL. NO: 08074308912, 09057355221


N10,000
Non refundable

APPLICATION FORM Affix One


Passport
A. PERSONAL DATA Photograph,
Write Your
Name & Sign
1. NAME OF APPLICANT/COMPANY (IN FULL) _____________________
_____________________________________________________________
2. AGE ______3. SEX____________4. MARITAL STATUS ______________
5. STATE OF ORIGIN________________6. TEL NO____________________
7. DATE OF BIRTH_____8. RESIDENTIAL ADDRESS (STREET, TOWN&
STATE) _____________________________________________________
9. PERMANENT HOME ADDRESS_________________________________
_____________________________________________________________
10. E-MAIL ADDRESS & POSTAL ADDRESS_________________________
_____________________________________________________________
11. OCCUPATION________________________________________________
12. OFFICE ADDRESS____________________________________________
13.NAME(S) OF DIRECTORS______________________________________
_____________________________________________________________
14.NAME & ADDRESS OF NEXT OF KIN____________________________
_____________________________________________________________
15.PHONE NUMBER & EMAIL ADDRESS OF NEXT OF KIN____________
_____________________________________________________________

B. HOW DID YOU KNOW ABOUT US


Agent Flier/Banner Social Media word of Mouth
If referred/Referrals name ______________________ Referral’s phone No__________________
++CATEGORY OF BUILDINGS

LA’ GRACE SITE COMFORT SITE EXPLIOT SITE GLORY SITE


4 bedroom duplex 4 bedroom Bungalow
4 Bedroom Duplex 4BEDROOM DUPLEX
3bedroom Duplex 3 bedroom Bungalow
3 Bedroom Duplex 3BEDROOM DUPLEX
4bedroom DUPLEX 4bedroom Bungalow

3 bedroom DUPLEX 3Bedroom Bungalow

C. MODE OF PAYMENT
FULL PAYMENT PART PAYMENT
-Note that payment should be made after the developer’s approval.
-Letter of allocation will issued on presentation of bank teller, showing payment and verification
of same from the bank.
-Default of any installment paid shall be viewed as withdrawal of interest in the service
plot/building initially allocated. Refund of any and all sum already paid by the allottee shall attract
20% admin charges.
D. DECLARATION
I, ________________________________whose name and address appears above declared that
the information/ statement are true and correct to the best of my knowledge.
And I promise to abide by the rules & regulations given by the developer.
Sign___________________________
FOR OFFICE USE ONLY
Installment Date Amount Balance Mode of Bank/Account Remarks
Plan Paid Payment Paid into
1st
2nd
3rd

Application Checked by: ________________________________________


Date: _________________Plot No/Unit(s) Allocation________________
Sign/Office Stamp

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