DEALER COPY

TordGo Further Docket no 446856

Order Booking Form

2 02
Model AspireVtcoSport Endeavour FH8o Freestyle
Customername(8LOCK LETERS)Msm Fitname NOVNEET KUMAT SINGa
Middle name Last name

Mglinig agdresuildina NOO 3 Flat301. Kavyad horo

OCieAy Dhokali Nalcacolct od ome -4ô0o
Ciy THAME State
PIN cOde Enal CNee.Sis44 omaj. Corm
PAN

STD code

Date of Birth
el Mobile 4S1os921
Date of wedding aniversery (if applicable)
Prefered communication method
Phone email SMS None
Vehicle registration address (if diferent than
mailing address)

PINcode
Booking date G 2 6 C21. Sales Consultantname LOSHNE
Variant booked
ECG-S1o»d SYoriS_Diesw preference
Tentative delivery during week starting
R O|2
Bookingamount * Paymenttype CashCheque/0/UTRn o t a Male UP/NEFT
Maximum recommended booking amount is 230.001- for Figo/Freestyle/Aspire/EcoSport, 750,000/- for Endeavour.

Amount in words eveM JeulcNaheque/DD/UTR/Digital Wallet/UPINEFT no

one Hlmdreda Elkven o4, Dated 2 2
Bank and Branch
Absent a force majeure event and providedthat the customer has complied with allterms and conditions, the Dealeship will pay simple interest
on the booking amount @8% per annum if the car is not delivered within 90 days after the booking date. For example, if the delivery is made on
the 100th day after the booking date, interest will be calculated for 10 days and applied towards the final payment. No interest will be payable if
the booking is cancelled.
ALL PAYMENTS BY CHEQUE/DD/RT6S MUST BE IN FAVOUR OF THE DEALERSH
REMEMBER TO COLLECT OFFICIAL RECEIPTS FROM THE DEALERSHIP
Mode of balance payment Cash Cheque/DD/UTR no Digital Wallet, UPI. NEFT
Gther_
Name of Banker/Financial institution
L
In the event of cancellation, the dealership wll process the refund due based on a written letter or email request from the customer. The dealership
will request in writing (letter/email) if anydocurnentsare required, for e,8.recelpt, ld proof, account details etc. within 24 hours on receijpt of the
cancellationrequestletter/emailfrom the customer. The dealership may also request (not mandatory) an affidavit, only if the customer is unable
to produce the 'original booking amOunt receipt".
IHAVE CAREFUuLLY READ, UNDERSTOOD AND SIGNED THE TERMS AND CONDITIONS PRINTED AT THE END OF THIS DOCKET AND
AGREE TO ABIDE BY ALLOF THEM.

Signature Signature SEnature Signature

Sales Consultant ASM/Team Leader SM/GM Customer

without prior notice.

Available features and specifications are subject change
to

2
 (USE BLOCK LETTERS)

Customername:Firstname Y . NAUMKE* CumaY S{rn, Discount offered

Middle name. Last name Consumer

Booking recelpt no Corporate/Fleet

Model Co5fo MS. Exchange

Variant 0rMS Dje Ja{ Accessories
Colour whie
Sales Consultant name LoShM Loyalty

SalesConsultant mobile no YE GUGO Insurance

Corporate/ Fleet Offer Other

NFP/Level A/Rental/Special Price/Canteen Cars/Fil Direct Billing/Employee/Friends & Family/ Total Discount Offered
NA (Circle One)
Price Calculation
Exshowroom Price Ex-City Marne ,69,00 O
A. RTO Company/Individual Charge
B. TCS (if applicable) >10 Lakhs
C. Temp Registration Charg
D. Insurance GOS38
E. Zero Depreciation InsUrance Premium
Kms
F. Extended Waranty/TMP/SSP Months or
G. Standard Accessories/Essential Kit

H. Extra Accessories and Services (from separate sheet)

On-Road Prlce (Invoice Price+A through H)**
Total Discount Offered

Net Payable J400 OOO

Payment Detalls
Booking amount
2 Amount financed

3 Trade-in value
Receipt no Date
4 Payment

5 Payment
Payment

Balance payable (if any)

Refund (if any)
Date

provide:
If insurance is provided through the Dealership, please

Nominee Nam
Relatlonship Age

Signature Signature Signature

Signature

ASM/Team Leader SM/GM Customer

Sales Consultant

submit eligibility documents.

The Customer might be required to and might increase or decrease due to changes by statutory authorities
or Ford.
on the date of delivery
Final On-Road Price will be determined
6
 Cord
RUDRAA FORD
Shri Salasar
Balaji Automobiles & Services Pvt.
Ltd.
Amisha Empire, Pleasant Park, Mira
Bhayander Rd, Mira Road-401107
Receipt No 1799
Dt:02.06.2021

Received with thanks from

RECEIPT
Mr Navneet Kumar
Singh
Rupees Eleven Thousand One Hundred&
Eleven only
By IMPS ref 115317447731 & 11531607241
Being payment received towards
Ecosport Diesel Titanium+ Sports BSVI 2021 D
White
Rs: 11,111/-

Hyp: State Bank Of India SA

SEAVICES
FRudraa Ford

AuthorisedSignatory

Note:

Price ruling at the time of delivery Applicable

Delivery after realization of full payment

Delivery after registration only