VILLA AVENUE HOUSING DEVELOPMENT S/B

APARTMENT SERVIS SENTROVUE -BLOCK A

No. 1-3-12, Apartment Servis Sentrovue A,
Jalan PPAJ 5, Pusat Perdagangan Alam Jaya,
42300 Banday Puncak Alam, Selangor.

Our ref: move in/out request refund form.A 190501

1-9-15
LOT Number : ____________________ Date : _____________

Re: Request for Refund of Move in Deposit Upon Completion of Move in Work

Kindly be informed that we had fully completed the Move in work at below date: _____________ 25-4-2019
therefore, kindly arrange to refund the Move In deposit of :

500.00
RM___________________ by cheque payable to below:

Anjiri bin Bolong

Owner Name: __________________________________, IC No. ________________________. 800907-12-5369
Tenant Name : _________________________________, IC No. __________________________.

Below Attached with my Transfer Slip & other related document:

1) Photo copy IC (for Cheque Issued use)

2) * If Tenant, please attach Tenancy Agreement.
2700.00
3) Transfer / Bank in Slip with amount RM: ______________. 112471656848
Ref No: _________________
05-April-2019
Date Transfer: ______________________.

Yours faithfully,

______________________________
Signature
Anjiri bin Bolong
Owner Name : __________________

Tenant Name: __________________

For Office Use :

Site Inspection by : _______________________________Name : ____________________________Date :_______________________

Reason(s) For Deduction: YES / NO

Refund detail:

Amount to Refund : RM __________________________, CHEQUE _______________________, Date : _______________________________