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Land Form

PERSONAL INFO
Surname Name * Other Names *
Maiden Name * Marital Status *
Date Of Birth Nationality *
Contact Address(Not P.O. Box) Email *
Mobile No. Mailing Address *

OTHER INFORMATION
Next Of Kin Relationship
Address(Redidential) Telephone No.
Email

APPLICANT'S EMPLOYMENT

Profession * Occupation *
Employer's Name * Employer's Tel No *
Employer's Full Address * Financial Options *

PAYMENT OPTIONS

Outright  By Installments 
Choice Of Estates * Choice Of Plots*
Employer's Full Address * Financial Options *

I hereby affirm that the information provided above in partial fulfillment of the requirement for the allocation of plot(s) of land in your estate(s) a indicate above is true. I accept that any inaccurate or false information given above and/or the non-endorsement or compliance with the Deed of Estate Covenants by me may result in the disqualification of my application. I also accept that this application in its entirety is subject to the availability of the option I have indicated herein and that PREIL shall not be liable if my application is returned as a result thereof. In any such event I also agree to accept the refund of money without any interest attached thereto.