Flat Owner Form by 5V5J1u

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									          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 :
    Mobile No.
    E-Mail ID :

3   Flat Co-Owner Name (2nd Name)
    Date of Birth/Age :
    Mobile No.:
    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
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