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Agent Registration : Enter Details
Note - For Photo,Pan and Aadhaar only jpg,png,jpeg Files are allowed having size less than 100KB
ApplicantType
Name
Proprietor
FatherName
State
District
Tehsil
Perament Address
Photograph
*
PanNumber
PanCopy
AadhaarNumber
Aadhar Copy
Email
*
Password
*
ConfirmPassword
*
Mobile
Registration Fee
PaymentDate
Transaction ID
*
Has your registration request ever refused in past?
No
Yes
Has your registration request ever revoked in past?
No
Yes
Reason
*
Chief Executive Officer Details:
PartnerName
x
*
PhotoGraph
Address
AadhaarNumber
PanNumber
Pan Copy
Email
Mobile
Aadhaar Copy
Add Executive Officer
Bank Details:
Account Number
Account Name
Bank Name
IFSC CODE
Branch Name
Branch Address
Documents:
Registration Certificate
*
Income Tax Returns
*
Remark
Address Proof
*
Remark
Other Document
Remark
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