FORM ‘REA-I’

[See rule 9(1)]

APPLICATION FOR REGISTRATION OF REAL ESTATE AGENT

To

The Haryana Real Estate Authority

Photo of the
Gurugram
Authorized
person

Sir,

[I/WE] apply for the grant of registration as a real estate agent to facilitate the sale or purchase
of any plot, apartment or building, as the case may be, in real estate projects registered in the
State of Haryana in terms of the Act and the rules and regulations made thereunder,

(A). In the case of an individual:-

i Name Devid kumar Sharma

ii Father’s Name
Shri Raj Kumar Sharma
iii Occupation
Business

iv Address
F-410-GF Sushant Lok-2, Ext Sector-57, Gurgaon
Haryana-122003.

v Contact Details Phone No.

9577799911
Email ID. davidgurgaon@gmail.com

Fax No.

(B). In the case of a proprietorship firm/society/company etc:-

i Name N/A

ii Registered Office
N/A

iii Principal Place of Business

N/A

iv Status of the applicant, whether

[company/proprietorship
firm/societies/partnership N/A
firm/limited liability partnership
etc.];
 v Contact Details of all Name N/A
partners and
directors etc. Phone No. N/A

Email Id N/A

Fax No. N/A

Photograph N/A

vi Copy of registration certificate N/A

vii Major Activities N/A

(C).

Particulars of registration including the N/A

bye-laws, memorandum of association,
articles of the association etc. as the
case may be;

(D).

Authenticated copy of the address proof LEASE DEED

of the place of business;

(E).

Details of the registration in any other N/A

State or Union Territory;

(F).

Any other information as specify by N/A

regulations;

(G). [I/WE ] enclose the following documents along with , namely:-

Demand Draft/Bankers Cheque No.

Dated

For a sum of 25000/-

In favor of

Drawn on
 Payable at Gurgaon

Attached Herewith

(H).

Authenticate copy of the PAN card of the BMDPS6470E

real estate agent

(I).

Authenticate copy of the registration as N/A

real estate agent in the other state or
Union Territory, if applicable

(J). [I/WE] solemnly affirm and declare that the particulars given in herein are correct to
[my/our] knowledge and belief and nothing materials has been concealed by [me/us] therefrom.

Dated: Yours faithfully,

Place: Signature and seal of the applicant(s)