Form VI

(See Regulation 6)
Complaints to the Regulatory Authority

For Office Use Only

Date of filing: __________________
Date of [receipt at the filing counter of the Registry/ receipt by post/ online filing]:
___________________
Complaint No.: ____________________
Signature: _______________________
Registrar: _______________________

IN THE REGULATORY AUTHORITY’S OFFICE OF ODISHA

Between
PRADIPTA MOHARANA__________________Complainant (s)

And
SRI TIRUPATI CHOUDHURY _____________________ Respondent (s)

Details of claim:
1. Particulars of the complainant(s):

i. Name(s) of the complainant: PRADIPTA MOHARANA

ii. Address of the existing office/residence of the complainant: Ghantapada,
Talcher, Dist: Angul-759103
iii. Address for service of all notices: Flat No. 204, SWARNA TOWER, BAREIPALI,
SAMBALPUR-768006
iv. Contact Details (Phone number, e-mail, Fax Number etc.): 9437078346,
p_moharana@hotmail.com

2. Particulars of the respondents:

i. Name(s) of respondent: SRI TIRUPATI CHOUDHURY

ii. Office address of the respondent: A/103, Saheed Nagar, Bhubaneswar-751007.
iii. Address for service of all notices: A/103, Saheed Nagar, Bhubaneswar-751007.
iv. Contact Details (Phone number, e-mail, Fax Number etc.): 2541164

3. Jurisdiction of the Authority:

The complainant declares that the subject matter of the claim falls within the
jurisdiction of the Authority.

4. Facts of the case:

[Give a concise statement of facts and grounds for complaint]

5. Relief(s) sought:
 In view of the facts mentioned in paragraph 4 above, the complainant prays for the
following relief(s)

____________________________________________.
[Specify below the relief(s) claimed explaining the grounds of relief(s) and the legal
provisions (if any) relied upon]

6. Interim order, if prayed for:

Pending final decision on the complaint the complainant seeks issue of the following
interim order:
[Give here the nature of the interim order prayed for with reasons]

7. Complainant not pending with any other court, etc.: The complainant further declares
that the matter regarding which this complaint has been made is not pending before
any court of law or any other authority or any other tribunal(s).
8. Particulars of [demand draft or online payment] in respect of the fee as specified
inregulation 13

i. Amount
ii. Name of the bank on which drawn
iii. [Demand draft number/ online payment transaction no.]

9. List of enclosures:

i. Copies of the documents relied upon by the complainant and referred to in the
complaint
ii. An index of documents
iii. Other documents as annexed along with the complaint

Signature of the complainant(s)

Verification

I PRADIPTA MOHARANA (name in full block letters), the complainant do hereby verify that the
contents of paragraphs [1 to 9] are true to my personal knowledge and belief and that I have
not suppressed any material fact(s).

Place:
Date:

Signature of the complainant(s)

 SCHEDULE OF THE PAYMENTS
Sl. Date of Amount Paid Mode of Payment DD, Cheque Money receipt
No. Payment (Rs.) (DD/Cheque/Cash) Number Number
1 16.03.2011 20,001.00 NEFT 1554/23.03.2011
2 25.03.2011 89,999.00 Cheque 911722 1554/23.03.2011
Amount paid by Punjab
3 28.04.2011 2,74,225.00
National Bank, BBSR 246/28.04.2011
4 28.04.2011 23,250.00 CASH 1786/28.04.2011
Amount paid by Punjab
5 09.07.2012 1,76,294.00
National Bank, BBSR 3193/09.07.2012
6 09.07.2012 15,618.00 NEFT 3193/09.07.2012
Total Amount Paid till
5,99,387.00 Which comes to 78.12% of total flat cost
date
 DOCUMENTS RELIED UPON

Sl. No. Particulars of Documents Page Nos.

1 Copy of Money Receipts. 1-3
2 Copy of Allotment letter 4
Copy of Agreement for Sale of Apartment /Flat, bearing
3 No. HHL-626 Dated: 31.03.2011 (as handed over by the 5-15
opposite party to the complainant).
4 Letters issued by the Opposite party.
Project will start & complete Dt. 07.09.2013 16
5 Bank statement regarding repayment of Principal &
17-30
Interest financial year wise from 27.04.11 to17.02.18
6 Legal notice sent to the opposite party. 31
7 Reply to the above legal notice by the opposite party 32
8 Copy of Identity Proof of the Complainant.
33
(Aadhaar Card)