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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
FatherName
State
District
Tehsil
Perament Address


PanNumber
PanCopy
AadhaarNumber
Aadhar Copy

Email   *
Password   *
ConfirmPassword   *
Mobile
Registration Fee
PaymentDate

Bank Details:

Account Number
Account Name
Bank Name
IFSC CODE
Branch Name
Branch Address