3.Approvals/ NOCs from various agencies for connecting external services.

Facility	External/ connecting service to be provided by (Name the agency)	Whether Approval taken from the agency concerned. Yes/No (Annex details in folder C)
ROADS	HSVP ALREDY CONNECTED	No
WATER SUPPLY	GMDA	Yes
ELECTRICITY	DHVBN	Yes
SEWAGE DISPOSAL	GMDA	Yes
STORM WATER DRAINAGE	GMDA	Yes

4.Details of services and facilities which will be provided inside the project area as per service plan estimates and/or the project report:

Sr. No.	Name of the facility	Estimated cost (In Lakhs)(Within the project area only)	Remarks: Yet to be prepared / Submitted to HUDA, Town & Country Planning Department/ as per project report etc. (Annex relevant documents showing costing details etc. in folder C)
1	INTERNAL ROADS AND PAVEMENTS	211.23	AS PER PROJECT REPORT
2	WATER SUPPLY SYSTEM	35.74	AS PER PROJECT REPORT
3	STORM WATER DRAINAGE	66.12	AS PER PROJECT REPORT
4	ELECTRICITY SUPPLY SYSTEM	99.98	AS PER PROJECT REPORT
5	SEWAGE TREATMENT & GARBAGE DISPOSAL	35.91	AS PER PROJECT REPORT
6	STREET LIGHTING	24.85	AS PER PROJECT REPORT
7	SECURITY AND FIRE FIGHTING	6.88	AS PER PROJECT REPORT
8	PLAYGROUNDS AND PARKS	91.98	AS PER PROJECT REPORT
9	CLUB HOUSE/COMMUNITY CENTRE	0	AS PER PROJECT REPORT
10	SHOPPING AREA	0	AS PER PROJECT REPORT
11	RENEWABLE ENERGY SYSTEM	0	AS PER PROJECT REPORT
12	SCHOOL	0	AS PER PROJECT REPORT
13	HOSPITAL/DISPENSARY	0	AS PER PROJECT REPORT
14	ANY OTHER	0	AS PER PROJECT REPORT
15	PARKING	6.54	AS PER PROJECT REPORT
16	STP	189.49	AS PER PROJECT REPORT
17	UWT	117.15	AS PER PROJECT REPORT
18	RAIN WATER HARVESTING	20.65	AS PER PROJECT REPORT
19	ELECTRICAL SUB STATION	142.32	AS PER PROJECT REPORT
20	SITE CLEANING	22.95	AS PER PROJECT REPORT
21	MISCELLANEOUS COSTS	344.21	AS PER PROJECT REPORT

5. (a) Date of approval of latest layout plans granted by Town & Country Planning Department on the basis of which the project will be executed.

22-03-2023 (date)

6. Date of approval of Building Plans

22-03-2023 (date)

7. New projects:

i) Likely date of starting the construction work

01-04-2023

ii) Likely date of completing the project

20-08-2025

iii) Sizes of the plots to be offered in the project

Plot Area(In Square Meter)	Number of plots in the project
126.75	14
126.99	5
127.38	1
176.13	1
127.23	1
138.73	1
138.81	1
174.93	1
100.73	1
100.65	1
111.15	4
166.47	1
131.64	1
122.33	1
136.11	1
159.90	1
159.59	1

iv. Type of apartments to be constructed in the project:

Type	Carpet area(In Square Meter)	Number of apartments	Number of towers
Apartment/Shops/Other Buildings	0	0	0

(vi) Quarterly schedule of development of whole/remaining part of the project:

(c) Apartments/Shops/Other Buildings

Expenditure incurred till the date of application (In Lakhs)

Particulars

Expenditure

Expenditure to be made in each quarter (In Lakhs)

Particulars	Expenditure to be made in each quarter ()
	Apr-June	July-Sep	Oct-Dec	Jan-Mar

(d) Infrastructure

Expenditure incurred till the date of application (In Lakhs)

Particulars	Expenditure
Roads & Pavements	0
Water Supply System	0
Sewerage treatment & garbage disposal	0
Electricity Supply System	0
Storm Water Drainage	0
Parks and Playgrounds	0
Clubhouse/community centres	0
Shopping area	0
Other	0

Expenditure to be made in each quarter (In Lakhs)

Particulars	Expenditure to be made in each quarter ()
	Apr-June	July-Sep	Oct-Dec	Jan-Mar

It is hereby stated and declared and the above information is correct and true and nothing has been concealed or misrepresented.

Signature of the Applicant / Authorised Representative
Stamp _____________
Date _____________

FORM REP-I

Part - D

Accounts related information:

1. Annex copy of the balance sheet of last 3 years

Yes

2. In case of on-going projects,cash flow statement since start of the project up-to-date in folder D.
Total receipt of funds, sources of funds and deployment of funds should be stated in tabulated form.

No

3. Bank account to which the deposits received from apartment buyers will be credited

Bank and Branch address

INDUSIND BANK LTD., BLOCK A, SUSHANT LOK, PHASE 1, TOWER B, FIRST INDIA PLACE, GROUND FLOOR, MG ROAD GURUGRAM-122001

Bank Account number

251901202301

IFSC code

INDB0000022

MICR code

110234004

Branch code

000022

4. Name and address of the person/persons who would ordinarily be operating the account (Change at any time must be intimated to the Authority)

Mr. Atul Jain, Adani House, Plot no. 83, Sec 32, Institutional area, Gurugram-122001

5. Attach certificate issued by a Chartered Accountant that the applicant has not defaulted in its debt liabilities in the past five years in folder D. (In case of default, give details)

Non- Default Certificate Uploaded

I hereby declare that the above information and particulars are based on record and are true to the best of my knowledge and belief and nothing has been concealed.

Signature of the Applicant / Authorised Representative
Stamp _____________
Date _____________

FORM REP-I
Part - E

Details of the statutory approvals:

1. Annex copies of the following in Folder E:

i. Lay out Plan		Yes
ii. Demarcation Plan		Yes
iii. Zoning Plan		Yes
iv. Building Plan		No
Site Plan		Yes
Floor Plan		Yes
Apartment Plans		No
Elevation Section		Yes
Detail of Permissible FAR		No
Detail of covered area achieved FAR		No

2. Annex copies of the following in Folder E:

I. ROADS AND PAVEMENT PLAN		Yes
II. ELECTRICITY SUPPLY PLAN		No
III. WATER SUPPLY PLAN		Yes
IV. SEWERAGE AND GARBAGE DISPOSAL PLAN		Yes
V. STROM WATER DRAINAGE		Yes
VI. 10% LAND TO BE TRANSFERRED TO THE GOVT. FOR COMMUNITY FACILITY		No
VII. STREET LIGHTING PLAN		No
VIII. PARKING PLAN		No

3. Statutory Approvals Status

Statutory Approvals	Statutory Approvals Status	Date
I. CONVEYANCE DEED	ALREADY BEEN OBTAINED	22-11-2018
II. LICENSE	ALREADY BEEN OBTAINED	21-08-2010
III. STANDARD DESIGN OF SCO OF COMMERCIAL SITE	ALREADY BEEN OBTAINED	22-03-2023

It is undertaken that the project shall be completed within the time schedule given in Part C and the same will not be delayed on account of non- receipt of any of the statutory approval. The liability for the non-receipt of any of the statutory approval shall be that of the promoter and in case of delay, compensation as per law may be given to the allottees.

Signature _____________
Seal _____________
Date _____________

FORM REP-I

Part - F

1. A copy of the draft allotment letter by which the apartment shall be allotted/ booked in favour of the apartment buyers.
(Annex a copy in Folder F)

Yes

2. A copy of the Draft Agreement which shall be made before seeking any deposit exceeding 10% of the cost of the apartment. (Based on the model agreement prescribed in the Rules)
(Annex a copy in Folder F)

Yes

3. Gist of the important provisions of the Draft Agreement
(Annex a copy in Folder F)

As per RERA prescribed format

I hereby declare that the above information and particulars are based on record and are true to the best of my knowledge and belief and nothing has been concealed.

Signature of the Applicant / Authorised Representative
Stamp _____________
Date _____________

FORM REP-I

Part - G

Projects launched by the promoter in last five years:

1. Name and location of the project

SAMSARA PART - V, SECTOR-63, GURUGRAM

2. Particulars of the project in brief:

i. Total area of the project

3.0253

ii. Total number of apartments

172

iii. Total number of plots

43

3. The number of plots/ apartments booked/sold to the allottees:

(a) Apartments

169

(b) Plots

0

4. Details of the expenditure incurred upto date:

	Initially estimated cost (In Lakhs)	Revised cost (In Lakhs)	Expenditure incurred upto the date of application (In Lakhs)
Total cost of the project (Other than cost of land)	22745	0	13811.35
Cost of the apartments	0	0	0
Cost of the infrastructure	3654	0	0
Others costs	6150	0	4359.81

5. Total amount of money collected from current allottees of the apartments/ plots upto the date of filing this application.

26969.61 Lakhs

6. Remaining amount of sale price money to be collected from the current allottees of the apartments.

10064.4 Lakhs

7. Loan sanctioned by the banks/ other financial institutions against the project.

0 Lakhs

8. Amount drawn from the banks/ other financial institutions till the date of filing this application.

0 Lakhs

9. Whether any litigation is pending against the Project:
Yes/No
(If yes-give Annex details in folder G)

No

10. Initial date of completion of the project.

30-09-2023

11. Likely date of completion of the project.

30-09-2023

1. Name and location of the project

SAMSARA VILASA & SAMSARA ARYA, BLOCK- M & J, BRAHMA CITY, SECTOR- 60 & 63, GURUGRAM

2. Particulars of the project in brief:

i. Total area of the project

1.8256

ii. Total number of apartments

84

iii. Total number of plots

21

3. The number of plots/ apartments booked/sold to the allottees:

(a) Apartments

25

(b) Plots

0

4. Details of the expenditure incurred upto date:

	Initially estimated cost (In Lakhs)	Revised cost (In Lakhs)	Expenditure incurred upto the date of application (In Lakhs)
Total cost of the project (Other than cost of land)	16008.93	0	2717.84
Cost of the apartments	9878.7	0	990.37
Cost of the infrastructure	0	0	0
Others costs	6130.23	0	1727.47

5. Total amount of money collected from current allottees of the apartments/ plots upto the date of filing this application.

749.1 Lakhs

6. Remaining amount of sale price money to be collected from the current allottees of the apartments.

9726 Lakhs

7. Loan sanctioned by the banks/ other financial institutions against the project.

0 Lakhs

8. Amount drawn from the banks/ other financial institutions till the date of filing this application.

0 Lakhs

9. Whether any litigation is pending against the Project:
Yes/No
(If yes-give Annex details in folder G)

No

10. Initial date of completion of the project.

31-12-2026

11. Likely date of completion of the project.

31-12-2026

1. Name and location of the project

SAMSARA AVASA, BLOCK- L, BRAHMA CITY, SECTOR- 63, GURUGRAM

2. Particulars of the project in brief:

i. Total area of the project

1.2296

ii. Total number of apartments

68

iii. Total number of plots

17

3. The number of plots/ apartments booked/sold to the allottees:

(a) Apartments

30

(b) Plots

0

4. Details of the expenditure incurred upto date:

	Initially estimated cost (In Lakhs)	Revised cost (In Lakhs)	Expenditure incurred upto the date of application (In Lakhs)
Total cost of the project (Other than cost of land)	10439.34	0	955.86
Cost of the apartments	6322.55	0	277.38
Cost of the infrastructure	0	0	0
Others costs	4116.79	0	678.48

5. Total amount of money collected from current allottees of the apartments/ plots upto the date of filing this application.

206.9 Lakhs

6. Remaining amount of sale price money to be collected from the current allottees of the apartments.

11247.1 Lakhs

7. Loan sanctioned by the banks/ other financial institutions against the project.

0 Lakhs

8. Amount drawn from the banks/ other financial institutions till the date of filing this application.

0 Lakhs

9. Whether any litigation is pending against the Project:
Yes/No
(If yes-give Annex details in folder G)

No

10. Initial date of completion of the project.

31-12-2026

11. Likely date of completion of the project.

31-12-2026

I hereby declare that the above information and particulars are based on record and are true to the best of my knowledge and belief and nothing has been concealed.

Signature of the Applicant / Authorised Representative
Stamp _____________
Date _____________

FORM REP-I

Part - H

SPECIFICATION OF CONSTRUCTION
Specification of apartments and other buildings including the following:
1	FLOORING DETAILS OF VARIOUS PARTS OF HOUSE	N.A
2	WALL FINISHING DETAILS	N.A
3	KITCHEN DETAILS	N.A
4	BATHROOM FITTINGS	N.A
5	WOOD WORK ETC	N.A
6	DOORS AND WINDOS FRAMES	N.A
7	GLASS WORK	N.A
8	ELECTRIC FITTINGS	N.A
9	CONDUCTING AND WIRING DETAILS	N.A
10	CUPBOARD DETAILS	N.A
11	WATER STORAGE	N.A
12	LIFT DETAILS	N.A
13	EXTERNAL GLAZINGS	N.A
13.1	WINDOWS/GLAZINGS	N.A
14	DOORS	N.A
14.1	MAIN DOORS	N.A
14.2	INTERNAL DOORS	N.A
15	AIR CONDITIONING	N.A
16	ELECTRICAL FITTINGS	N.A
17	CNG PIPE LINE	N.A
18	PROVISION OF WIFI AND BROADBAND FACILITY	N.A
19	EXTERNAL FINISHING/COLOUR SCHEME	N.A
20	INTERNAL FINISHING	N.A

SPECIFICATION UNIT WISE
	1 . LIVING/DINING/FOYER/FAMILY LOUNGE
1 . 1	FLOOR	N.A
1 . 2	WALLS	N.A
1 . 3	CEILING	N.A
	2 . MASTER BEDROOM/DRESSROOM
2 . 1	FLOOR	N.A
2 . 2	WALLS	N.A
2 . 3	CEILING	N.A
2 . 4	MODULAR WARDROBES	N.A
	3 . MASTER TOILET
3 . 1	FLOOR	N.A
3 . 2	WALLS	N.A
3 . 3	CEILING	N.A
3 . 4	COUNTERS	N.A
3 . 5	SANITARY WARE/CP FITTINGS	N.A
3 . 6	FITTING/FIXTURES	N.A
	4 . BED ROOMS
4 . 1	FLOOR	N.A
4 . 2	WALLS	N.A
4 . 3	CEILING	N.A
4 . 4	WARDROBES	N.A
	5 . TOILET
5 . 1	FLOOR	N.A
5 . 2	WALLS	N.A
5 . 3	CEILING	N.A
5 . 4	COUNTERS	N.A
5 . 5	SANITARY WARE/CP FITTINGS	N.A
5 . 6	FIXTURES	N.A
	6 . KITCHEN
6 . 1	FLOOR	N.A
6 . 2	WALLS	N.A
6 . 3	CEILING	N.A
6 . 4	COUNTERS	N.A
6 . 5	FIXTURES	N.A
6 . 6	KITCHEN APPLIANCES	N.A
	7 . UTILITY ROOMS/UTILITY BALCONY/TOILET
7 . 1	FLOOR	N.A
7 . 2	WALLS & CEILING	N.A
7 . 3	TOILET	N.A
7 . 4	BALCONY	N.A
	8 . SIT-OUTS
8 . 1	FLOOR	N.A
8 . 2	WALLS & CEILING	N.A
8 . 3	RAILINGS	N.A
8 . 4	FIXTURES	N.A

I hereby declare that the above information and particulars are based on record and are true to the best of my knowledge and belief and nothing has been concealed.

Signature of the Applicant / Authorised Representative
Stamp _____________
Date _____________

List of Uploaded Documents

Sr. No.	Document Description	Date of Document Upload	View Document
1	ASSURANCE FOR WATER SUPLY	02-03-2023	------
2	ENVIRONMENTAL CLEARANCE	02-03-2023	------
3	ASSURANCE FOR SEWERAGE CONNECTION	02-03-2023	------
4	SERVICE PLANS SHOWING THE SERVICES ON THE LAYOUT PLAN	03-03-2023	View Document
5	CERTIFICATE FROM A CHARTERED ACCOUNTANT CERTIFYING THAT THE INFORMSTION PROVIDED BY THE APPLICANT IN FORM REP-1-C-X IS CORRECT AS PER THE BOOKS OF ACCOUNTS/ BALANCE SHEET OF THE APPLICANT	02-03-2023	View Document
6	DOCUMENTS RELATING TO THE ENTRY OF LICENSE AND COLLABORATION AGREEMENT IN THE REVENUE RECORD	02-03-2023	View Document
7	NON DEFAULT CERTIFICATE FROM A CHARTERED ACCOUNTANT	02-03-2023	View Document
8	MUTATION COPY	02-03-2023	------
9	PERT CHART	02-03-2023	------
10	CONVEYANCE DEED	02-03-2023	------
11	AKS SIZRA	02-03-2023	------
12	BANK UNDERTAKIN	02-03-2023	------
13	FOREST NOC	02-03-2023	------
14	ZONING PLAN	02-03-2023	View Document
15	DECLARATION SUPPORTED BY AFFIDAVIT DULY SIGNED BY THE PROMOTER TO BE ENCLOSED.	03-03-2023	View Document
16	JAMABANDI COPY	02-03-2023	------
17	PROMOTER AFFIDAVIT	03-03-2023	------
18	NON ENCUMBRANCE CERTIFICATE	02-03-2023	------
19	NOC	02-03-2023	------
20	COPY OF LICENSE ALONG WITH SCHEDULE OF LAND	03-03-2023	View Document
21	ASSURANCE FOR STORM WATER CONNECTION	02-03-2023	------
22	FLOOR PLAN-2	31-03-2023	------
23	SECTION AND ELEVATION PLAN-2	31-03-2023	------
24	IN CASE OF GROUP HOUSING/ COMMERCIAL SITES, A COPY OF THE APPROVED SITE PLAN	31-03-2023	View Document
25	CASH FLOW STATEMENT OF THE PROPOSED PROJECT	27-04-2023	View Document
26	SECTION AND ELEVATION PLAN-1	31-03-2023	------
27	FLOOR PLAN-1	31-03-2023	------
28	FLOOR PLAN-3	31-03-2023	------
29	ACS APPROVALS	22-06-2023	------
30	IN CASE OF PLOTTED COLONY, THE LATEST LAYOUT PLAN	22-06-2023	View Document

I hereby declare that the above information and particulars are based on record and are true to the best of my knowledge and belief and nothing has been concealed.

Signature of the Applicant / Authorised Representative
Stamp _____________
Date _____________

HRERA Gurugram		Temp Project Id : RERA-GRG-PROJ-1306-2023
		Submission Date : 03-03-2023 12:52:47 PM
		Applicant Type : Company
		Project Type: NEW