Personal Information Full Name Gender Male Female Age Phone Number Email Current Address Info Home Address Shop Address Next of Kin Name Address of next of kin Phone of next of kin Company Information Company Name Reg No Company Address Floor Ground Floor Upper Floor Are you interested in our financing option, if yes please state amount Yes No Conditions Of Sale (a) I/We agree that the acceptance of this application does not guarantee the offer to me/us of a shop(s) and that my/our application may be rejected without giving any reason for doing so (b) I/We agree that if I am offered shop(s) and I/We accept the offer, I/We may be required to settle the amount/balance within the stipulated number of days as maybe contained in the letter of offer Declaration Declaration (a) I/We Do hereby solemnly and sincerely declare that the information given on this application form is true and correct to the best of my/our knowledge, information and belief. I/We hereby undertake to the Management of Jakarta Plaza Onitsha that any lot(s) which will be allocated in response to this application shall be held in accordance with the provisions of agreement entered with Ora Egbunike & Associates Send
