Application Form For Participating In Chemmanur Gold Purchase Plan (GPP)
NAME SECOND / FAMILY NAME
NAME OF COMPANY            MARITAL STATUS M S
DESIGNATION PO BOX.
DATE OF BIRTH STATE


NATIONALITY LABOUR CARD
PASSPORT NUMBER E-MAIL
MAILING ADDRESS TELEPHONE OFFICE


RESI


MOBILE




FULL NAME AND ADDRESS OF AUTHORISED NOMINEE      


SPECIMEN SIGNATURE OF AUTHORISED NOMINEE _____ __________________________________________
COUNTERSIGNED BY PARTICIPANT
INSTALLMENT AMOUNT                     (Dhs)
REFERENCE                                        

THE MANAGER, CHEMMANUR JEWELLERS LLC , PO BOX 30611, ABU DHABI,UAE

DATE :
Dear Sir,
I apply for participation in your GOLD PURCHASE PLAN (GPP) and enclose my cheque/cash for Dhs (inclusive of documentation fees ) as my first payment to this plan. I accept all the terms and conditions governing the plan and acknowledge that a copy has been supplied to me .

     
Yours faithfully,
     


Customer no :    Approved by :      Expected date :
Delivered date :            As per my GPP No.   I have received all ornaments intact.
Participant's signature : ______________________________________________________________