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Registration - Information for Admin
Registration Date: May 18, 2022
All * Marked Fields are required.
1
Introducer Details
Introducer Name
*
Mobile No.
*
2
Personal Details
Agency Type
*
Select
Individual
Firm
Firm Name
*
First Name
*
Middle Name
Last Name
*
Birth Date
Select Gender
*
Select
Male
Female
Email
Mobile Number
*
Whatsapp Mobile No.
3
Address Details
Your Address
*
Country
*
Select
India
State
*
Select
Andaman and Nicobar Islands
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadra and Nagar Haveli
Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Ladakh
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Puducherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Telangana
Uttar Pradesh
Uttarakhand
West Bengal
District
*
Select
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City
Select City
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Pincode
4
Document Details
Pan Card No.
Aadhaar Card no.
*
GST No.
5
Farming Profile
खेती है?
कौनसी फसले लेते है?
कितने क्षेत्र में?
6
Nominee Details (Note : *Nominee's age Must be above 18.)
Name
Nominee Relation
Birth Date
7
Bank Account Details
A/C Holder Name
Account No.
Bank Name
IFSC Code.
Account Type
Branch Name
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