Complaint Registration Form

Details of the Complainant

Name of Complainant^*

Telephone Number

Mobile Number^*

EmailId ^*

Permanent Address

Address line 1^*

Address line 2^*

State^*

District/Region^*

Pin Code^*

Correspondent Address Same as above

Address line 1^*

Address line 2^*

State^*

District/Region^*

Pin code^*

Details of the Respondent

Name of Respondent ^*

Telephone Number

Mobile Number

Email Address

Permanent Address

Address line 1

Address line 2

State

District/Region

Pin Code

Correspondent Address Same as above

Address line 1

Address line 2

State

District/Region

Pin Code

Details of the Complaint

Subject of Complaint^*

Location^*

Type Of Development^*

Please select Type of Development.

Nearest Landmark

Facts of Complaint^*

Relief Sought from RERA

Interim Order Required^*

Yes No

SupportingDocuments

DELETE

Caption:

Attachment:

Add More

Payment

Payment Mode^*

Bank Name^*

Amount (INR)^*

Branch^*

DD/ Cheque No.^*

Attach Scan Copy^*

Declarations

I verify that the contents of the above sections are true to my personal knowledge and belief and I have not suppressed any material fact(s)