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.