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Government of India

Directorate of Estates
Subject: Application for Advance Booking of Accommodation at OOTY HOLIDAY HOME
This is an application form, and not booking confirmation. Confirmation letter is issued separately on receipt of DD.

Booking Request Details


Booking Request ID: 29102 Dated: 19-09-2010 Type: DOUBLE BED ROOM NON-AC
Booking Period Applied From :11-10-2010 To: 13-10-2010 Check Out: 14-10-2010 (FN)
No. of Nights: 3 Nature of Visit: PERSONAL Request Sent to: DOE-CHENNAI
Applicant's Particulars
Guest Category: CENTRAL GOVERNMENT SERVING ID Card/PPO No.: AC06701
Name: SHAMBHULAL DHAKER Designation: SCI/ENGR 'SF'
Office: SAC/ISRO AHMEDABAD E-mail: [email protected]
Phone: 07926914535 Fax: Mobile: 09913343575
Address for Communication
SCQAD/SAC/ISRO AHMEDABAD-15

Details of Visitors
Name Age Relationship
MR SHAMBHULAL DHAKER 47 SELF
MR KARTIK 8 SON
MR MOHIT 14 SON
MRS RAMLILA DHAKER 41 WIFE
Payment Details (Demand Draft - Not Refundable)
DD No.: 127198 Date: 17-09-2010 Amount (in Rs): 189
Bank: SBI
Declaration
(A) I declare that the accommodation asked for in the Guest House/Holiday Home, will be occupied by me/family members and guests, as declared
above. I will be responsible to make good any loss/damage to property,fixtures,fittings,furnishings during the booking period.I undertake to vacate the
accommodation as per check-out time specified above. I will not overstay without the written permission of the Alloting Authority,otherwise I/family
members/my guests will be liable to pay market rate of License Fee as damages as decided by Dte. of Estates and face physical eviction from the
occupied premises. I am aware that i will not be entitled to claim refund of the advance booking amount and i will not ask for the refund in case the
requested accommodation is not utilized by me,after submission of this application.
(B) I declare that the information given above is correct and nothing has been concealed/misprinted. I shall also abide by the terms and conditions
governing this allottment as given on the website of Dte. of Estate. I also undertake to take meals, etc. in the Holiday Home/Hostel, if catering
arangement is available and to pay the applicable charges directly to the caterer/ Caretaker.I undertake that I will not withdraw my application for
booking .In case the cheque (given by me as advance payment) is dishonoured for any reason, I authorize my DDO to deduct equal amount from my
salary and remit the same to the Dte of Estates, on receipt of their damand.

Date Place Signature of Applicant


To be verified by the Administrative Office of applicant
(Applications not verified by the Adminstrative office of applicant will not be entertained)
(a) Certified that Shri/Smt./Kum. SHAMBHULAL DHAKER
,
Designation SCI/ENGR 'SF' is a permanent employee
, of this office.
(b) Office Category (Please Tick):
Central govt. Ministry Central PSU/Semi Govt. Office of State Other Retd. employees annex copy of
/ Department Office Govt/ U.T. Admn (Please specify) PPO

(c) The certified copy of the tour program, specifying the period and place of official journey is enclosed. (if applicable)

Endorsement No Date Signature with Office Seal


This application is to be despatched with DD (drawn in favour of ASSISTANT ESTATE MANAGER, CHENNAI )
to the Allotting Authority mentioned below:
SH. M. H. BATCHA , ASSTT. ESTATE MANAGER
FIRST FLOOR, SHASTRI BHAWAN, HADDOWS ROAD, CHENNAI

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