ON STAMP PAPER OF RS. 200/-
[To be given by the member for civil repairing work / Alteration work in the flat. ]
I/We ______ son/daughter of______ Age___ residing at the _____ Indian inhabitant , state as under:
I/ We ______ residing at _____ , who was the member of the ____ Co-operative Housing Society Ltd., having address at ___
I/We ______ holding the Share Certificate No. ___ for ten paid up shares Rupees Fifty each, bearing Distinctive number from____ to ____ [both inclusive].
I/We ______ holding the Flat No. ____ on ____ floor, admeasuring ___ Sq. Meters in the building of the Society, known / Numbered as _____ constructed on the plot of land bearing No. _____ at _____.
I/We have made application for civil repairing work / alteration work in our flat of the said Society and for that we have submitted the Plan copy / Drawing copy of our Architect /Inter Designer.
I/We undertake that we will carry repair/alteration work as per plan given to the Society. I/We also undertake that we will also take necessary permission from Municipal Corporation /Municipal Council through our Architect /Inter Designer. If any change in the plan we inform the Society as well Municipal Corporation /Municipal Council as in written.
I/We also undertake that due to this repair/alteration work any damage OR leakage occurs in neighboring flat i.e. Flat which is above, below , left & right in our flat we will repair it to our cost and keep the Society indemnified to it. I/We also undertake that at the time of resale of the flat we inform the new Buyer regarding this Indemnity & undertaking for civil repair / alteration work.
I/We hereby Indemnify and keep indemnified and harmless the said Society and its any of the office-bearers against any claim, demand, suit or other legal proceedings by Any other persons, Municipal Corporation /Municipal Council, Any semi Government Office or Government Office , claiming lawfully and/or equitably, I/We further declare and Undertake to bear all expenses, cost, charges in respect of any such claim, demand, suit and/or legal proceedings which may be filed by any other persons, Municipal Corporation /Municipal Council , Any semi Government Office or Government Office , either lawfully and/or equitable.
I/We am/are conscious of the fact that the Society will give the permission of civil repair/alteration work on the basis of this indemnity and undertaking.
I/We make this declaration solemnly, believing the same to be true and having faith therein
Solemnly declared at ____ by the within named & photo Signature of Flat Owner’s / Applicant .
On this _____ day of _____20 Before Me
[Notary / Magistrate ]