USH OFFICE ADDRESS:
OMES No 26, T.O.S Benson Crescent,
Opposite National Assembly Service
Commission,
Utako, Abuja.
KYAMI PAVILLION ESTATE
SUBSCRIPTION FORM
TYPE OF PLOTS: STRICTLY RESIDENTIAL SERVICED PLOTS COMMERCIAL PLOTS
PAYMENT: 0-3months (interest free) 6months (5% increase)
ESTATE NAME:
NUMBER OF PLOTS: PLOT SIZES: 150sqm 200sqm 250sqm 300sqm
350sqm 400sqm 450sqm 500sqm
BLOCK OF FLATS: 1 BEDROOM 2 BEDROOM 3 BEDROOM
KINDLY FILL THE FORM WITH BLOCK LETTERS AND WITH CORRECT DETAILS
SECTION 1: SUBSCRIBER’S DETAILS
TITLE: MR/MRS/MS/MISS/DR/PROF/CHIEF/OTHER
NAME:
DATE OF BIRTH: d GENDER: MALE FEMALE:
d
d kkllk
(RESIDENTIAL ADDRESS
d IN UPPER CASE)
PERMANENT ADDRESS:f
HHJJHH
STATE OF ORIGIN: COUNTRY:
OCCUPATION:
ORGANIZATION NAME:
EMAIL ADDRESS:
MARITAL STATUS: NATIONALITY:
TEL: POSTAL CODE:
MEANS OF IDENTIFICATION: NATIONAL ID DRIVER’S LICENCE INTERNATIONAL PASSPORT
IDENTITY NUMBER EXPIRY DATE
SECTION 2: NEXT OF KIN DETAILS
NAME:
RELATIONSHIP: TEL.:
EMAIL ADDRESS:
RESIDENTIAL ADDRESS:
(If buying as a Company)
SECTION 3: CORPORATE INFORMATION
CORPORATE NAME:
CORPORATE ADDRESS:
CONTACT NAME:
CORRESPONDENCE ADDRESS:
TELEPHONE NUMBER:
EMAIL ADDRESS:
SECTION 4: RELEVANT DOCUMENTS
CERTIFICATE OF INCORPORATION BY CAC BOAR OF RESOLUTION AUTHORIZING PURCHASE
MEMORANDUM AND ARTICLES OF ASSOCIATION CERTIFIED BY CAC
FORM CAC 7 (PARTICULARS OF DIRECTORS) FORM CAC 2 (RETURN OF ALLOTMENT OF SHARES)
FORM CAC 10 (ANNUAL RETURN)
SECTION 5: REFERRAL DETAILS
NAME:
PHONE NUM:
EMAIL:
WEB SOCIAL MEDIA
And I/We hereby declare that I/We fully understand the terms and
conditions regarding this purchase and I/We consent to same.
SECTION 6: SUBSCRIBER’S DECLARATION
SIGNATURE OF THE SUBSCRIBER
DATE
SECTION 7: BANK DETAILS
BANK NAME: HUSH HOMES LTD
S/N BANK ACCOUNT NUMBER
1 TAJ BANK 0006172395
