TEMA DEVELOPMENT CORPORATION ORIGINAL

SERVICE RESIDENTIAL PLOT

PLEASE AFFIX
A. PARTICULARS OF APPLICANT: PASSPROT SIZE
PHOTOGRAPH
1. Full Name (Mr/Mrs/Ms/Mad)

………………………………………………………………………………..
2. Registered Business Address

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3. Postal Address (If Different from 2):

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Tel No: ……………………… Fax No: ………………………………

4. Residential Address: ………………………………………………………….

………………………………………………………………………………...

Tel No: …………………….. Email: ………………………………...

5. Nationality: ………………… Resident/Non Resident……………….

Age: ……………………….

B. PARTICULARS OF PLOT:

1. A. Community No:………… B. Block No:…………. C. Plot No: …………

2. D. Selling Price: ……….. E. Single/ Two Storey…………. F. Plot Size……...

…………………………… ………………………………...
Date Signature of Applicant(s)
………………………………………………………………………………………………
C. FOR OFFICE USE ONLY: Customer No: ……………………..

1. A. Community No: ………. B. Block No: ……………. C. Plot No: ………...

2. D. Selling Price: ………… E. Single/ Two Storey.

3. Amount Paid: a. Full [ ] b. part [ ]

4. Payments:
i. GH¢…………… $....................... Rec. No: …………… Date: ……………….
ii. GH¢…………… $....................... Rec. No: …………… Date: …………….....
iii. GH¢…………… $....................... Rec. No: …………… Date: ……………….
iv. GH¢…………… $....................... Rec. No: …………… Date: ……………….
v. GH¢…………… $....................... Rec. No: …………… Date: ……………….
vi. GH¢…………… $....................... Rec. No: …………… Date: ……………….
vii. GH¢…………… $....................... Rec. No: …………… Date: ……………….
Viii GH¢…………… $....................... Rec. No: …………… Date: ……………….

TOTAL

Remarks: ………………………………………………………………………….
…………………………………………………………………………………….
Officer’s Signature ……………………….. Date: …………………………..