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FOR CANCELLATION AND ADJUST

(To be executed in Rs. 10/- Non-judicial Stamp Paper)

AFFIDAVIT CUM UNDERTAKING

I/We, _________________________________ S/D/W of ___________________________ R/o ___________________________________ and _______________________________ S/D/W of ______________________________ R/o _______________________________, do hereby solemnly affirm, declare and undertake as under: 1. That I/ We have booked a Residential Flat/ Villa/ Plot bearing No. __________ in __________ Tower admeasuring ________ Sq.ft./Sq.mtr/Sq.yrd. proposed to be built/ developed in _______________ at ______________________ (herein after referred to as the said Unit) by M/s. ____________________________________ having its Registered Office at _____________________________, (hereinafter referred to as the said Company). That I/ We have made payment of Rs.__________ (Rupees ______________ _____________________________) towards the booking and installment of the said Unit in the aforesaid project and the Company has issued the following Receipt(s) to me/ us. i) ii) iii) iv) 3. Receipt No. _________ dated ______ for Rs. _____________________ Receipt No. _________ dated ______ for Rs. _____________________ Receipt No. _________ dated ______ for Rs. _____________________ Receipt No. _________ dated ______ for Rs. _____________________

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That I/we have executed an Allotment Letter/ Agreement dated ________ for provisional allotment of the said unit by the Company. That I/we have not entered into any further agreement, contract, understanding etc. with any person for assignment of my allotment right in the said Unit, nor have created any liens, charges, mortgages, encumbrances etc. on the said Unit. That now I/we wish to surrender the booking of said Unit in the aforesaid project to the Company will fully, voluntarily and without any undue pressure/coercion and requested the Company to complete the formalities as per the terms of the Application Form/ Allotment Letter/ Agreement executed by me/us. That I/we have agreed that the Company shall refund Rs. ____________ (Rupees _____________________________________________) to me/us against cancellation of my/our booking (herein after referred to Refundable Amount) as per the terms of the Application Form/ Allotment Letter/ Agreement executed by me/us.

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That I/we have requested the Company not to refund me/us the said Refundable Amount and to adjust the said Refundable Amount to the credit of Unit No. ___________ in ___________ Tower measuring ___________ sq.ft. built in ______ Project booked in the name of ___________________________________. That I/we hereby submit/ surrender the original copy of the said of the Allotment Letter/ Agreement, aforesaid Receipt(s) and other relevant application form, documents etc. with the said Company for cancellation and I/we swear and affirm that the said receipt, application form, documents etc. are genuine and authentic and I/we have not used the photocopy of the said document for any other purpose. That I/ we undertake that, upon cancellation of the said Unit at my/ our request by the company, neither I/we nor anybody else claiming through me/ us, shall have any right, title, interest etc. in the aforesaid Unit and the company is free to deal with the said Unit at its sole discretion. That I/ we further undertake that, upon adjustment of the said Refundable Amount to the credit of Unit No. ___________ in ___________ Tower measuring ___________ sq.ft. built in _________ project booked in the name of ______________________, neither I/we nor anybody else claiming through me/ us, shall make any further claim against the said Company based on the said receipt, application form, agreement etc. and I/ we bind myself/ ourselves to deal with any such claims on my/ our own and keep the said Company absolved of any liability in this regard. That in case the said Company suffers any losses, damages or claims, consequent to its adjustment of my/our said Refundable Amount to the credit of Unit No. ___________ as aforesaid based on my/our aforesaid representation/ documentation, I/ we undertake to indemnify and keep indemnified the said Company and its staff and employees and the said nominee(s) to the extent of such losses, damages or claims.

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DEPONENT(S)

VERIFICATION: Verified at ___________ on this ____ day of _____________ that the contents of Para 1 to 10 of above Affidavit cum Undertaking are true to the best of my/our knowledge and belief and nothing material has been concealed therefrom.

DEPONENT(S)