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Nagalakshmi Nagar, Survey No. 33 to 36, Madurai - Rajapalayam Road, T.Kunnathur,
Peraiyur Taluk, Madurai District, Pin Code - 625708.
NAGALAKSHMI NAGAR - GREEN PARK

HOUSING SITE
APPLICATION FOR BOOKING
BOOKING DATE           
CUSTOMER CODE       

PHOTO
 
        CUSTOMER NAME          MR/MRS/MISS
1      

        S/O / D/O / W/O
           DOB   

        NOMINEE NAME
       

        CUSTOMER NAME          MR/MRS/MISS
2      

        S/O / D/O / W/O
           DOB   

        NOMINEE NAME
        

ADDRESS




MOB.NO. PIN CODE
PHONE NO 1 PHONE NO 2
EMAIL ID 1 EMAIL ID 2
PLOT NO SFT
TOTAL COST Rs INSTALMENT PATTERN Rs. X Months
 
Cheques / DD Details
S.No.Date Recpt.No Chq.No/D.D Bank Name Branch Name City Amount
1
2
3
4
5
6
7
8
9
10
 

AGENT (SIGN.)                                                       

" I have read the entire terms & conditions printed on the reverse of the application form, I have understood
the entire terms & conditions and agree to abide by the same"

CUSTOMER (SIGN.)                                                                                              CUSTOMER (SIGN.)                                                     


FOR OFFICE USE

LAND REGISTERED ON                                                 DOC.NO                                                 PLOT NO                                              

SURVEY NO                                                                  TOTAL EXT.                                      


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