Date:

To

M/s Vipul Limited

Vipul Tech Square,
Golf Course Road, Sector 43,
Gurgaon 122 009 (Haryana)
Subject: Provisional Application for Registration of Tatvam Villa in your Project Vipul World, Gurgaon
Dear Sir(s),
I/ We am / are enclosing herewith Cheque/ Draft/ Pay order no. dated for
Rs(Rupees......
.only) drawn on
(Bank & Branch) in favour of Vipul Limited. which may please be treated as an advance payment for
Registration.
My/ Our particulars as mentioned below may be recorded for reference and communications:
First Applicant

Second applicant

Mr./Mrs./Ms.

Mr./Mrs./Ms...

Son/daughter/Wife of..

Son/daughter/Wife of

Address.

Address..

..

City..State..

City..State..

Residential Status: Resident / Non-Resident Indian/Foreign

National of Indian Origin
Nationality .

Residential
Status:
Resident
/
Indian/Foreign National of Indian Origin
Nationality .

Phone/Mobile.

Phone/Mobile.

Fax/E-Mail

Fax/E-Mail.

*PAN No

*PAN No.

ITO Ward No.

ITO Ward No.

*PAN Photocopy Mandatory

*PAN Photocopy Mandatory

Non-Resident

I/ We request that my / our name may be registered for Tatvam Villa in your project Vipul World, Gurgaon
having a tentative size of:

960 Sq. yds.

752 Sq. yds.

502 Sq. yds.

358 Sq.Yds

Yours faithfully,

(FIRST APPLICANT)

Place..

(SECOND APPLICANT)

287 Sq. yds.

DECLARATION

I/ We, the undersigned Intending applicant (Sole/First and Second Intending Applicant), do hereby declare that the abovementioned particulars/ information given by me/ us are true and correct to my/ our knowledge and no material fact has
been concealed there from.
Name of the Applicant(s): 1. 2.
Signature(s): 1. ...

2. ..

Place: Date:

Notes:
1. All Drafts/ Cheque are to be made in favour of VIPUL LIMITED, payable at Delhi/New Delhi.
2. The Drafts/ Cheque are accepted subject to realization.

FOR OFFICE USE ONLY

1.

Application Accepted /Rejected

:.

2.

Size of a Villa

:.

3.

Villa Number

:.

4.

Booking

Direct / Broker

Dated: ..

Authorized Signatory

.............................................................................................

ACKNOWLEDGEMENT

Received Rs. (Rupees..) vide

Cheque No... Dated drawn on from
Mr./Mrs./Ms. ....towards request for Provisional Application for Registration of
a Plot in Vipul World Gurgaon.

__________________________________
(On behalf of Vipul Limited.)
Date:

__________________________________
(Name of Broker)