Shanti Garden-Sector 6, Bldg. No. 10 to 17 Co.Op. Housing Society Ltd.
Flat Owner Information Details Form
1 Flat No.- Bldg. No. - Sector-6
Shanti Garden, Mira Road ( E)-401107
1st Name ( Photo) 2nd Name (Photo)
2 Flat Owner Name (1st Name)
Date of Birth/Age / Male Or Female :
E-Mail ID :
3 Flat Co-Owner Name (2nd Name)
Date of Birth/Age :
E- Mail ID:
4 Flat Address ( Full Address With Tel. No.)
5 Flat Owner Office Address & Tel.No.
6 Flat Owner Native Place Address:
7 Family Members Name & Relationship
8 Nominee Name & Age:
9 Do you have Cable Connection ( Yes /No.)
If Yes - then Name Of Cable operator
10 Do you have Internet Connection ( Yes /No.)
If Yes - then Name of Service Provider
11 Do you have Gas Connection ( Yes /No.)
If Yes - then Name of Gas Service Provider
12 Do you have Car ( Yes /No.)
If Yes - then CAR no.
13 Do you have Motor Cycle ( Yes /No.)
If Yes - then Motor Cycle No.
14 Do you have Parking Slot ( Yes /No.)
If Yes - then Parking Slot No.& Bldg. No.
Declaration by flat Owner: The above mentioned information True & correct with my signature
( Flat Owner Name & Signature) ( Committee Member Name & Sign.)
Emergency Mobile No.:
Chairman / Secretary
( Signature )
Enclosed Documents : 1) Flat Agrement Copy with Stamp Duty & Reg. copy
2) Nomination Form
3) Power of Attorney Copy
4) All Documents with Hard board file