Title *

 Mr.   Mrs.   Ms.

Name-name *

I.D. number. *

Phone number. *

Example: 08xxxxxxxx

Name of legal entity/company/partnership

Legal entity registration number / Tax identification number

Name of person authorized to sign on behalf of juristic person

Position of authorized person to sign

Legal entity phone number

Legal entity email

Name-Surname of the person giving power of attorney

ID card number of the grantor

Name-Last name of the attorney

ID card number of the attorney

Telephone number of the attorney

Authorisation date

Construction site location *

Land rights document *

-- Select --Land title deedNor Sor 3 Kor land documentNor Sor 3 land documentALROOther

Number/land number/deed number *

Land area (rai)

Land area (ngan)

Land area (square wah)

House type *

-- Select --Detached houseSemi-detached houseTownhouse/TownhomeOther

Number of floors *

Total usable area (sq m) *

Estimated construction value (baht)

Name of Supervisor/Engineer/Architect

License number/professional license