Title* Affix Passport Photograph
    Surname Name * Other Names *
    Date Of Birth Nationality *
    Passport No. Visa No. *
    Date & Validity Mailing Address*
    City Country
    Postal Code Current Address
    Residential Tel. No. Office Tel. No.
    Mobile No. Email *
    Next Of Kin Relationship
    Contact Address Telephone
    Email Registration No
    Country of Registration Authorized Representative Name


    House Types *


    Payment Options

    I hereby affirm that I am not less than 18 years; that I have carefully read through this form before filling it and that the information provided above in partial fulfillment of the requirement for purchase of house(s) in your Estate(s) as indicated 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 availability of the option I have indicated herein and that PREIL shall not be held liable if my application is returned as a result thereof. In any such event, I also agree to accept the refund of my money without any interest attached thereto. I further accept that in the event that I withdraw from scheme PREIL shall have the right to deduct an administrative charge of 20% of the price of the house from the money I have deposited.