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<html>
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<head>
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amit.gupta |
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<script src="${rc.contextPath}/resources/fofo-form/js/jquery-1.10.2.min.js"></script>
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<link rel="stylesheet" href="${rc.contextPath}/resources/fofo-form/css/bootstrap.min.css"/>
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<link rel="stylesheet" type="text/css" href="${rc.contextPath}/resources/fofo-form/css/main.css"/>
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<!-- Optional theme -->
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<link rel="stylesheet" href="${rc.contextPath}/resources/fofo-form/css/bootstrap-theme.min.css" />
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<!-- Latest compiled and minified JavaScript -->
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<script src="${rc.contextPath}/resources/fofo-form/js/bootstrap.min.js"></script>
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<script src="${rc.contextPath}/resources/fofo-form/js/bootstrapValidator.js"></script>
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<script src="${rc.contextPath}/resources/fofo-form/js/reg.js"></script>
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<script src="${rc.contextPath}/resources/fofo-form/js/reqformvalidator.js"></script>
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<script src="${rc.contextPath}/resources/fofo-form/js/fofoedit.js"></script>
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<script src="${rc.contextPath}/resources/fofo-form/js/jquery.blockUI.js"></script>
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<script type="text/javascript">
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contexPath = "${rc.contextPath}";
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var jsonObj= $fofoForm;
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$(document).ready(function(){
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readForm();
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$("input[name$='bEntity']").click(function() {
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var test1 = $(this).val();
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$(".box").hide();
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$('input[name=dinNumber]').each(function(){
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$(this).prop('disabled', true);
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});
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var dinNumberInput = $("#sale"+test1+ " input[name=dinNumber]");
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if (dinNumberInput.prop('disabled') == true){
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dinNumberInput.prop('disabled', false);
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}
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$("#sale" + test1).show();
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});
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});
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</script>
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<script type="text/javascript">
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$(document).ready(function(){
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$("input[name$='bPmpDetail']").click(function() {
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var test1 = $(this).val();
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$(".pmp").hide();
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$("#Pmp" + test1).show();
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});
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});
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</script>
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<script type="text/javascript">
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$(document).ready(function(){
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$("input[name$='shopStatus']").click(function() {
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var test1 = $(this).val();
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$("#shopsemifurnished, #shopfullfurnished").find("input[type=checkbox]").each(function(){
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$(this).prop('disabled', true);
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});
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$(".status").hide();
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$("#shop" + test1).show();
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$("#shop" + test1).find("input[type=checkbox]").prop('disabled', false);
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});
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});
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</script>
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<script type="text/javascript">
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$(document).ready(function(){
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$("input[name$='sellingOnline']").click(function() {
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var test1 = $(this).val();
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$(".Names").hide();
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$("#selling" + test1).show();
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});
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});
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</script>
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<script type="text/javascript">
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$(document).ready(function(){
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associateValidator();
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$("input[name$='insurance']").click(function() {
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var test1 = $(this).val();
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$(".doc").hide();
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$("#doc" + test1).show();
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});
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});
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</script>
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<script type="text/javascript">
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docsArray = ['doc_bEntityDoc','doc_gstDoc','doc_panDoc','doc_itrDoc','doc_angleDoc1','doc_angleDoc2','doc_angleDoc3','doc_angleDoc4','doc_angleDoc5','doc_ownershipDoc','doc_insuranceDoc','doc_loanDoc','doc_sanctionDoc','doc_chequeCopy'];
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$(document).ready(function(){
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$("input[name$='loan']").click(function() {
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var test1 = $(this).val();
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$(".document").hide();
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$("#document" + test1).show();
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$("#showHide").show();
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});
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docsArray.forEach(function(inputName){
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$('input[name="' + inputName + '"]').change(function(e){
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var formData = new FormData();
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that = this;
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formData.append("file", $(this)[0].files[0]);
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jQuery.ajax({
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url: window.location.hostname + ":8080/profitmandi-web/document-upload",
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type: 'POST',
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data: formData,
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cache: false,
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contentType: false,
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processData: false,
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success: function (data) {
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console.log(data);
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hiddenInput = inputName.split("_")[1];
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var doc_id = 0;
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if (data.response.document_id == 0){
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alert(data.response.message);
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return;
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}
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$('input[name="' + hiddenInput + '"]').val(data.response.document_id);
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validator.data('bootstrapValidator').revalidateField($('input[name="' + hiddenInput + '"]'));
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}
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});
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});
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});
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});
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function queryStringToJSON(queryString) {
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var pairs = queryString.split('&');
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var result = {};
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pairs.forEach(function(pair) {
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pair = pair.split('=');
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result[pair[0]] = decodeURIComponent(pair[1] || '');
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});
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return result;
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}
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/*var oResult ={Branchname: "jnkmk",DinNumber: "8327592895",ExperienceinTelecome: "kdnslgrgjemgk",GSTNoDate: "29309238033902",IFSCcode: "kmk",IncomeTaxPanNo: "8384705257029",Insurance: "no",Managementstaff: "9392",MobileNo: "3288702375",North: "",ProprietorAddress: "nsdln",Proprietoremail: "jnefkji",Proprietorowner: "nsja",Proprietorpan: "nsdjak",Proprietorphone: "84u50",ProprietorusineesName: "mnsdvns",RegisteredAddress1: "wz-127 tilak nagar",RegisteredAddress2: "",RegisteredAddress3: "",RegisteredBusinessName: "spice+mobile",accountnumber: "nk",bEntity: "Partnership",bPmpdetail: "Proprietor",bankname: "kmk",businessmodel: "Retailer",city: "delhi",contactemail1: "84300293-92",contactemail2: "",contactname1: "nas+c",contactname2: "",contactno1: "8435092",contactno2: "",descriptionofExistingbusiness: "jsdnkglelr",east: "34",front: "",loan: "yes",location: "shoppingMall",neareststore: "100mtrs",noofemployess: "823u9",ownership: "Rented",partnerAddress1: "",partnerAddress2: "",partnerAddress3: "",partnerAddress4: "",partnerName1: "",partnerName2: "",partnerName3: "",partnerName4: "",partneremail1: "",partneremail2: "",partneremail3: "",partneremail4: "",partnerowner1: "",partnerowner2: "",partnerowner3: "",partnerowner4: "",partnerpan1: "",partnerpan2: "",partnerpan3: "",partnerpan4: "",partnerphone1: "",partnerphone2: "",partnerphone3: "",partnerphone4: "",pincode: "110018",portalName1: "",portalName2: "",portalName3: "",roadsize: "",sellingonline: "no",shareholderAddress1: "",shareholderAddress2: "",shareholderAddress3: "",shareholderAddress4: "",shareholderName1: "",shareholderName2: "",shareholderName3: "",shareholderName4: "",shareholderemail1: "",shareholderemail2: "",shareholderemail3: "",shareholderemail4: "",shareholderowner1: "",shareholderowner2: "",shareholderowner3: "",shareholderowner4: "",shareholderpan1: "",shareholderpan2: "",shareholderpan3: "",shareholderpan4: "",shareholderphone1: "",shareholderphone2: "",shareholderphone3: "",shareholderphone4: "",shopArea: "on",shopAvailbility: "Groundfloor",shopWashroom: "Washroom",shopWater: "Watersupply",shopstatus: "fullfurnished",south: "49",state: "Haryana",storeAddress: "",storename: "",telno: "7597209570",west: "32"}*/
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function jQFormSerializeArrToJson(formSerializeArr){
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var jsonObj = {};
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jQuery.map( formSerializeArr, function( n, i ) {
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jsonObj[n.name] = n.value;
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});
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return jsonObj;
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}
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</script>
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<style>
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.loading-image {
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position: fixed;
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top: 50%;
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left: 50%;
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margin-top: -50px;
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margin-left: -100px;
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z-index: 100;
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}
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</style>
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</head>
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<body>
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<div class="container">
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<div class="row">
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<div class ="header">
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<h3 class="header">HOTSPOT PARTNER STORE</h3>
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<h4 class="header">Powered by Profit Mandi (A Unit of Spice Group)</h4>
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</div>
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<div class="header">
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<h5 class="header">APPLICATION FOR REGISTRATION</h5>
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</div>
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<hr />
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<div class="row">
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<div class="col-sm-8">
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<form role="form" name="myform" id ="form" enctype="multipart/form-data" data-toggle="validator" novalidate>
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<input type="hidden" name="_id" value="0"/>
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<h4 class="page-header">1. Registered Business Name of HSPS (in Block Letters)</h4>
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<div class="form-group ">
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<label for=""></label>
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<input type="text" name="registeredBusinessName" id="demo" class="bform" placeholder="Business Name" style="text-transform:uppercase;"/>
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</div>
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<h4 class="page-header">2. Registered Address (In Block Letters)</h4>
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<div class="form-group float-label-control">
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<label for="">Line 1</label>
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<input type="text" name ="line1" class="form-control" placeholder="Line 1" style="text-transform:uppercase;">
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</div>
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<div class="form-group float-label-control">
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<label for="">Line 2</label>
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<input type="text" name ="line2"class="form-control" placeholder="Line 2" style="text-transform:uppercase;">
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</div>
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<div class="form-group float-label-control">
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<label for="">Line 3</label>
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<input type="text" name="line3" class="form-control" placeholder="Line 3" style="text-transform:uppercase;">
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</div>
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<div class="form-group float-label-control">
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<label for="">City</label>
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<input type="text" name="city" class="form-control" placeholder="City" style="text-transform:uppercase;">
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</div>
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<div class="form-group float-label-control">
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<label for="">District</label>
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<input type="text" name="district" class="form-control" placeholder="District" style="text-transform:uppercase;">
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</div>
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<div class="form-group float-label-control">
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<label for="">Pincode</label>
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<input type="text" name="pincode" maxlength="6" class="form-control" pattern="[0-9]{6}" title="Please enter correct Pin Code"placeholder="Pincode" style="text-transform:uppercase;">
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</div>
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<div class="form-group float-label-control">
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<select class="form-control" name = "state" placeholder="State">
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<option value=" ">State</option>
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<option value="Andaman and Nicobar Islands">Andaman and Nicobar Islands</option>
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<option value="Andhra Pradesh">Andhra Pradesh</option>
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<option value="Arunachal Pradesh">Arunachal Pradesh</option>
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<option value="Assam">Assam</option>
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<option value="Bihar">Bihar</option>
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<option value="Chandigarh">Chandigarh</option>
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<option value="Chhattisgarh">Chhattisgarh</option>
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<option value="Dadra and Nagar Haveli">Dadra and Nagar Haveli</option>
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<option value="Daman and Diu">Daman and Diu</option>
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<option value="Delhi">Delhi</option>
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<option value="Goa">Goa</option>
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<option value="Gujarat">Gujarat</option>
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<option value="Haryana">Haryana</option>
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<option value="Himachal Pradesh">Himachal Pradesh</option>
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<option value="Jammu and Kashmir">Jammu and Kashmir</option>
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<option value="Jharkhand">Jharkhand</option>
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<option value="Karnataka">Karnataka</option>
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<option value="Kerala">Kerala</option>
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<option value="Lakshadweep">Lakshadweep</option>
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<option value="Madhya Pradesh">Madhya Pradesh</option>
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<option value="Maharashtra">Maharashtra</option>
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<option value="Manipur">Manipur</option>
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<option value="Meghalaya">Meghalaya</option>
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<option value="Mizoram">Mizoram</option>
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<option value="Nagaland">Nagaland</option>
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<option value="Orissa">Orissa</option>
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<option value="Pondicherry">Pondicherry</option>
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<option value="Punjab">Punjab</option>
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<option value="Rajasthan">Rajasthan</option>
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<option value="Sikkim">Sikkim</option>
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<option value="Tamil Nadu">Tamil Nadu</option>
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<option value="Tripura">Tripura</option>
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<option value="Telangana">Telangana</option>
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<option value="Uttaranchal">Uttaranchal</option>
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<option value="Uttar Pradesh">Uttar Pradesh</option>
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<option value="West Bengal">West Bengal</option>
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</select>
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</div>
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<div class="form-group float-label-control">
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<label for="">Email1</label>
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<input type="email" class="form-control" name="registeredEmail1" placeholder="Email1" readonly value="${email}" style="text-transform:uppercase;">
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</div>
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<p>Example:- xyz<strong>.hsps@gmail.com</strong></p>
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<div class="form-group float-label-control">
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<label for="">Email2</label>
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<input type="email" class="form-control" name="registeredEmail2" placeholder="Email2" style="text-transform:uppercase;">
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</div>
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<div class="form-group float-label-control">
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<label for="">Mobile</label>
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<input type="text" class="form-control" name="mobile" maxlength = "10" pattern="[0-9]{10}" title="Please enter valid Phone number" placeholder="Mobile" style="text-transform:uppercase;">
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</div>
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<label>Landline</label>
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<div class="form-group Pmpform">
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<input type="text" name="stdcode" maxlength = "5" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="STDcode" style="text-transform:uppercase;"/>
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<input type="text" name="telephone" maxlength = "10" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="Telephone" style="text-transform:uppercase;"/>
|
| 22095 |
kshitij.so |
290 |
</div>
|
|
|
291 |
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292 |
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293 |
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|
294 |
<h4 class="page-header">3. Type of Business Entity</h4>
|
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295 |
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296 |
<div class="funkyradio">
|
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297 |
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298 |
<div class="funkyradio-primary">
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299 |
<input type="radio" name="bEntity" id="radio1" value="SaleProprietorship" required>
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300 |
<label for="radio1">Proprietor</label>
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|
301 |
</div>
|
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|
302 |
<div class="funkyradio-primary">
|
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|
303 |
<input type="radio" name="bEntity" id="radio2" value="Partnership" required>
|
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304 |
<label for="radio2">Partnership</label>
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305 |
</div>
|
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|
306 |
<div class="funkyradio-primary">
|
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|
307 |
<input type="radio" name="bEntity" id="radio3" value="PrivateLimitedCompany" required>
|
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308 |
<label for="radio3">Private Limited company</label>
|
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309 |
</div>
|
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|
310 |
<div class="funkyradio-primary">
|
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|
311 |
<input type="radio" name="bEntity" id="radio4" value="LimitedLiabilityPartnership" required>
|
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|
312 |
<label for="radio4">Limited Liability Partnership</label>
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313 |
</div>
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314 |
</div>
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|
315 |
<div class ="Entity">
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316 |
<div class="SaleProprietorship box" id ="saleSaleProprietorship">Upload <strong>Proprietership proof</strong></div>
|
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|
317 |
<div class="partnership box" id="salePartnership">Upload <strong>Partnership Deed</strong></div>
|
|
|
318 |
</div>
|
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|
319 |
<div class="limitedcompany box" id="salePrivateLimitedCompany">
|
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|
320 |
<div class="form-group float-label-control">
|
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|
321 |
<label for="">DIN Number</label>
|
| 22534 |
ashik.ali |
322 |
<input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
323 |
</div>Upload <strong>Incorporation certificate,Memorandum & Article of association</strong>
|
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324 |
</div>
|
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325 |
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326 |
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|
327 |
<div class="LimitedLiabilityPartnership box" id="saleLimitedLiabilityPartnership">
|
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|
328 |
|
|
|
329 |
|
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|
330 |
<div class="form-group float-label-control">
|
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|
331 |
<label for="">DIN Number</label>
|
| 22534 |
ashik.ali |
332 |
<input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
333 |
</div>Upload <strong>Registration certificate & partnership Deed</strong>
|
|
|
334 |
</div>
|
|
|
335 |
|
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|
336 |
<div class = "form-group file upload">
|
|
|
337 |
<input type="file" accept="application/pdf,image/*" id="doc" name ="doc_bEntityDoc">
|
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|
338 |
|
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|
339 |
<input type="hidden" name="bEntityDoc"/>
|
|
|
340 |
</div>
|
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|
341 |
|
|
|
342 |
<h4 class="page-header">4. Goods And Services Tax Number(GST)</h4>
|
|
|
343 |
<div class="Pmpform">
|
|
|
344 |
|
|
|
345 |
<input type="text" name="gst" class="bform" placeholder="Goods And Services Tax Number"/>
|
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|
346 |
</div>
|
|
|
347 |
<p>Provide Copy of GST document</p>
|
|
|
348 |
<div class = "file upload">
|
|
|
349 |
<input type="file" accept="application/pdf,image/*" name ="doc_gstDoc">
|
|
|
350 |
<input type="hidden" name="gstDoc"/>
|
|
|
351 |
</div>
|
|
|
352 |
|
|
|
353 |
|
|
|
354 |
<h4 class="page-header">5. Permanent Account Number(PAN)</h4>
|
|
|
355 |
<div class="form-group ">
|
|
|
356 |
|
|
|
357 |
<label for=""></label>
|
| 22534 |
ashik.ali |
358 |
<input type="text" name="pan" maxlength="10" class="bform" placeholder="Permanent Account Number" style="text-transform:uppercase;"/></div>
|
| 22095 |
kshitij.so |
359 |
<p>Provide Copy of PAN </p>
|
|
|
360 |
|
|
|
361 |
<div class = "form-group file upload">
|
|
|
362 |
|
|
|
363 |
<input type="file" accept="application/pdf,image/*" name="doc_panDoc">
|
|
|
364 |
<input type="hidden" name="panDoc"/>
|
|
|
365 |
</div>
|
|
|
366 |
|
|
|
367 |
|
|
|
368 |
<h4 class="page-header">6. Full Details Of Business Entity</h4>
|
|
|
369 |
|
|
|
370 |
<div class="funkyradio">
|
|
|
371 |
<div class="funkyradio-primary">
|
|
|
372 |
<input type="radio" name="bPmpDetail" id="business1" value="Proprietor" required>
|
|
|
373 |
<label for="business1">Proprietor</label>
|
|
|
374 |
</div>
|
|
|
375 |
<div class="funkyradio-primary">
|
|
|
376 |
<input type="radio" name="bPmpDetail" id="business2" value="Partners" required>
|
|
|
377 |
<label for="business2">Partners</label>
|
|
|
378 |
</div>
|
|
|
379 |
<div class="funkyradio-primary">
|
|
|
380 |
<input type="radio" name="bPmpDetail" id="business3" value="Directors" required>
|
|
|
381 |
<label for="business3">Directors</label>
|
|
|
382 |
</div>
|
|
|
383 |
</div>
|
|
|
384 |
|
|
|
385 |
<div class="tablecontainer">
|
|
|
386 |
<table class="businessdetail">
|
|
|
387 |
<tr>
|
|
|
388 |
<th class ="PMPName">Name</th>
|
|
|
389 |
<th class="PMPAddress">Address</th>
|
|
|
390 |
<th class="PMPtelno">Mobile</th>
|
|
|
391 |
<th class="PMPpan">PAN</th>
|
|
|
392 |
<th class="PMPAdhaar">Aadhaar Number</th>
|
|
|
393 |
<th class="PMPemail">Email</th>
|
|
|
394 |
<th class="PMPownership">Share %</th>
|
|
|
395 |
|
|
|
396 |
</tr>
|
|
|
397 |
<tr>
|
|
|
398 |
|
| 22534 |
ashik.ali |
399 |
<td class="form-group"><input type="text" name="proprietorBusineesName"size="25" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
400 |
<td class="form-group"><textarea row="3" name="proprietorAddress"></textarea></td>
|
| 22534 |
ashik.ali |
401 |
<td class="form-group"><input type="text" name="proprietorPhone" maxlength="10" pattern="[0-9]{10}"size="10" style="text-transform:uppercase;"></th>
|
|
|
402 |
<td class="form-group"><input type="text" name="proprietorPan" maxlength="10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
|
|
|
403 |
<td class="form-group"><input type="text" name= "proprietorAdhaar" size="15" style="text-transform:uppercase;"></td>
|
|
|
404 |
<td class="form-group"><input type="email" name= "proprietorEmail" size="20" style="text-transform:uppercase;"></td>
|
|
|
405 |
<td class="form-group"><input type="text" pattern="[0-9]" name="proprietorOwner" size="10" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
406 |
|
|
|
407 |
</tr>
|
|
|
408 |
|
|
|
409 |
|
|
|
410 |
</table>
|
|
|
411 |
|
|
|
412 |
</div>
|
|
|
413 |
<div class="Partners pmp" id= "PmpPartners">
|
|
|
414 |
<table class="businessdetail">
|
|
|
415 |
|
|
|
416 |
<tr>
|
|
|
417 |
<th class ="PMPName">Name</th>
|
|
|
418 |
<th class="PMPAddress">Address</th>
|
|
|
419 |
<th class="PMPtelno">Mobile</th>
|
|
|
420 |
<th class="PMPpan">PAN</th>
|
|
|
421 |
<th class="PMPAdhaar">Aadhaar Number</th>
|
|
|
422 |
<th class="PMPemail">Email</th>
|
|
|
423 |
<th class="PMPownership">Share %</th>
|
|
|
424 |
|
|
|
425 |
</tr>
|
|
|
426 |
<tr>
|
|
|
427 |
|
| 22534 |
ashik.ali |
428 |
<td class="form-group"><input name="partnerName1"type="text" size="25" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
429 |
<td class="form-group"><textarea name="partnerAddress1" type="text" size="60"></textarea></td>
|
| 22534 |
ashik.ali |
430 |
<td class="form-group"><input name = "partnerPhone1" pattern="[0-9]{10}"type="text" size="10" style="text-transform:uppercase;"></th>
|
|
|
431 |
<td class="form-group"><input name ="partnerPan1"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
|
|
|
432 |
<td class="form-group"><input name="partnerAdhaar1" type="text" size="15" style="text-transform:uppercase;"></td>
|
|
|
433 |
<td class="form-group"><input name="partnerEmail1" type="email" size="20" style="text-transform:uppercase;"></td>
|
|
|
434 |
<td class="form-group"><input name="partnerOwner1" type="text"pattern="[0-9]"size="10" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
435 |
|
|
|
436 |
</tr>
|
|
|
437 |
|
|
|
438 |
|
|
|
439 |
</table>
|
|
|
440 |
|
|
|
441 |
<table class="businessdetail">
|
|
|
442 |
|
|
|
443 |
<tr>
|
|
|
444 |
<th class ="PMPName">Name</th>
|
|
|
445 |
<th class="PMPAddress">Address</th>
|
|
|
446 |
<th class="PMPtelno">Mobile</th>
|
|
|
447 |
<th class="PMPpan">PAN</th>
|
|
|
448 |
<th class="PMPAdhaar">Aadhaar Number</th>
|
|
|
449 |
<th class="PMPemail">Email</th>
|
|
|
450 |
<th class="PMPownership">Share %</th>
|
|
|
451 |
|
|
|
452 |
</tr>
|
|
|
453 |
<tr>
|
|
|
454 |
|
| 22534 |
ashik.ali |
455 |
<td class="form-group"><input name="partnerName2"type="text" size="25" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
456 |
<td class="form-group"><textarea name="partnerAddress2" type="text" size="60"></textarea></td>
|
| 22534 |
ashik.ali |
457 |
<td class="form-group"><input name = "partnerPhone2" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
|
|
|
458 |
<td class="businesspan"><input name ="partnerPan2"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
|
|
|
459 |
<td class="form-group"><input name="partnerAdhaar2" type="text" size="15" style="text-transform:uppercase;"></td>
|
|
|
460 |
<td class="form-group"><input name="partnerEmail2" type="email" size="20" style="text-transform:uppercase;"></td>
|
|
|
461 |
<td class="form-group"><input name="partnerOwner2" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
462 |
|
|
|
463 |
</tr>
|
|
|
464 |
|
|
|
465 |
</table>
|
|
|
466 |
<table class="businessdetail">
|
|
|
467 |
<tr>
|
|
|
468 |
<th class ="PMPName">Name</th>
|
|
|
469 |
<th class="PMPAddress">Address</th>
|
|
|
470 |
<th class="PMPtelno">Mobile</th>
|
|
|
471 |
<th class="PMPpan">PAN</th>
|
|
|
472 |
<th class="PMPAdhaar">Aadhaar Number</th>
|
|
|
473 |
<th class="PMPemail">Email</th>
|
|
|
474 |
<th class="PMPownership">Share %</th>
|
|
|
475 |
|
|
|
476 |
</tr>
|
|
|
477 |
<tr>
|
|
|
478 |
|
| 22534 |
ashik.ali |
479 |
<td class="form-group"><input name="partnerName3"type="text" size="25" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
480 |
<td class="form-group"><textarea name="partnerAddress3" type="text" size="60"></textarea></td>
|
| 22534 |
ashik.ali |
481 |
<td class="form-group"><input name = "partnerPhone3" type="text" maxlength = "10" pattern="[0-9]{10}" size="10" style="text-transform:uppercase;"></th>
|
|
|
482 |
<td class="form-group"><input name ="partnerPan3"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
|
|
|
483 |
<td class="form-group"><input name="partnerAdhaar3" type="text" size="15" style="text-transform:uppercase;"></td>
|
|
|
484 |
<td class="form-group"><input name="partnerEmail3" type="email" size="20" style="text-transform:uppercase;"></td>
|
|
|
485 |
<td class="form-group"><input name="partnerOwner3" pattern="[0-9" type="text" size="10" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
486 |
|
|
|
487 |
</tr>
|
|
|
488 |
|
|
|
489 |
|
|
|
490 |
</table>
|
|
|
491 |
|
|
|
492 |
|
|
|
493 |
|
|
|
494 |
<table class="businessdetail">
|
|
|
495 |
<tr>
|
|
|
496 |
<th class ="PMPName">Name</th>
|
|
|
497 |
<th class="PMPAddress">Address</th>
|
|
|
498 |
<th class="PMPtelno">Mobile</th>
|
|
|
499 |
<th class="PMPpan">PAN</th>
|
|
|
500 |
<th class="PMPAdhaar">Aadhaar Number</th>
|
|
|
501 |
<th class="PMPemail">Email</th>
|
|
|
502 |
<th class="PMPownership">Share %</th>
|
|
|
503 |
</tr>
|
|
|
504 |
<tr>
|
|
|
505 |
|
| 22534 |
ashik.ali |
506 |
<td class="form-group"><input name="partnerName4"type="text" size="25" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
507 |
<td class="form-group"><textarea name="partnerAddress4" type="text" size="60"></textarea></td>
|
| 22534 |
ashik.ali |
508 |
<td class="form-group"><input name = "partnerPhone4" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
|
|
|
509 |
<td class="form-group"><input name ="partnerPan4"type="text" maxlength = "10"title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
|
|
|
510 |
<td class="form-group"><input name="partnerAdhaar4" type="text" size="15" style="text-transform:uppercase;"></td>
|
|
|
511 |
<td class="form-group"><input name="partnerEmail4" type="email" size="20" style="text-transform:uppercase;"></td>
|
|
|
512 |
<td class="form-group"><input name="partnerOwner4" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
513 |
|
|
|
514 |
</tr>
|
|
|
515 |
|
|
|
516 |
|
|
|
517 |
</table>
|
|
|
518 |
|
|
|
519 |
</div>
|
|
|
520 |
|
|
|
521 |
|
|
|
522 |
<div class="Directors pmp" id= "PmpDirectors">
|
|
|
523 |
<table class="businessdetail">
|
|
|
524 |
<tr>
|
|
|
525 |
<th class ="PMPName">Name</th>
|
|
|
526 |
<th class="PMPAddress">Address</th>
|
|
|
527 |
<th class="PMPtelno">Mobile</th>
|
|
|
528 |
<th class="PMPpan">PAN</th>
|
|
|
529 |
<th class="PMPAdhaar">Aadhaar Number</th>
|
|
|
530 |
<th class="PMPemail">Email</th>
|
|
|
531 |
<th class="PMPownership">Share %</th>
|
|
|
532 |
|
|
|
533 |
</tr>
|
|
|
534 |
<tr>
|
| 22534 |
ashik.ali |
535 |
<td class="form-group"><input name="shareholderName1"type="text" size="25" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
536 |
<td class="form-group"><textarea name="shareholderAddress1" type="text" size="60"></textarea></td>
|
| 22534 |
ashik.ali |
537 |
<td class="form-group"><input name = "shareholderPhone1" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
|
|
|
538 |
<td class="form-group"><input name ="shareholderPan1"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
|
|
|
539 |
<td class="form-group"><input name="shareholderAdhaar1" type="text" size="15" style="text-transform:uppercase;"></td>
|
|
|
540 |
<td class="form-group"><input name="shareholderEmail1" type="email" size="20" style="text-transform:uppercase;"></td>
|
|
|
541 |
<td class="form-group"><input name="shareholderOwner1" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
542 |
|
|
|
543 |
</tr>
|
|
|
544 |
|
|
|
545 |
|
|
|
546 |
</table>
|
|
|
547 |
|
|
|
548 |
<table class="businessdetail">
|
|
|
549 |
<tr>
|
|
|
550 |
<th class ="PMPName">Name</th>
|
|
|
551 |
<th class="PMPAddress">Address</th>
|
|
|
552 |
<th class="PMPtelno">Mobile</th>
|
|
|
553 |
<th class="PMPpan">PAN</th>
|
|
|
554 |
<th class="PMPAdhaar">Aadhaar Number</th>
|
|
|
555 |
<th class="PMPemail">Email</th>
|
|
|
556 |
<th class="PMPownership">Share %</th>
|
|
|
557 |
</tr>
|
|
|
558 |
<tr>
|
| 22534 |
ashik.ali |
559 |
<td class="form-group"><input name="shareholderName2"type="text" size="25" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
560 |
<td class="form-group"><textarea name="shareholderAddress2" type="text" size="60"></textarea></td>
|
| 22534 |
ashik.ali |
561 |
<td class="form-group"><input name = "shareholderPhone2" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
|
|
|
562 |
<td class="form-group"><input name ="shareholderPan2"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
|
|
|
563 |
<td class="form-group"><input name="shareholderAdhaar2" type="text" size="15" style="text-transform:uppercase;"></td>
|
|
|
564 |
<td class="form-group"><input name="shareholderEmail2" type="email" size="20" style="text-transform:uppercase;"></td>
|
|
|
565 |
<td class="form-group"><input name="shareholderOwner2" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
566 |
|
|
|
567 |
</tr>
|
|
|
568 |
</table>
|
|
|
569 |
|
|
|
570 |
<table class="businessdetail">
|
|
|
571 |
<tr>
|
|
|
572 |
<th class ="PMPName">Name</th>
|
|
|
573 |
<th class="PMPAddress">Address</th>
|
|
|
574 |
<th class="PMPtelno">Mobile</th>
|
|
|
575 |
<th class="PMPpan">PAN</th>
|
|
|
576 |
<th class="PMPAdhaar">Aadhaar Number</th>
|
|
|
577 |
<th class="PMPemail">Email</th>
|
|
|
578 |
<th class="PMPownership">Share %</th>
|
|
|
579 |
|
|
|
580 |
</tr>
|
|
|
581 |
<tr>
|
| 22534 |
ashik.ali |
582 |
<td class="form-group"><input name="shareholderName3"type="text" size="25" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
583 |
<td class="form-group"><textarea name="shareholderAddress3" type="text" size="60"></textarea></td>
|
| 22534 |
ashik.ali |
584 |
<td class="form-group"><input name = "shareholderPhone3" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
|
|
|
585 |
<td class="form-group"><input name ="shareholderPan3" type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
|
|
|
586 |
<td class="form-group"><input name="shareholderAdhaar3" type="text" size="15" style="text-transform:uppercase;"></td>
|
|
|
587 |
<td class="form-group"><input name="shareholderEmail3" type="email" size="20" style="text-transform:uppercase;"></td>
|
|
|
588 |
<td class="form-group"><input name="shareholderOwner3" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
589 |
|
|
|
590 |
</tr>
|
|
|
591 |
|
|
|
592 |
</table>
|
|
|
593 |
|
|
|
594 |
<table class="businessdetail">
|
|
|
595 |
<tr>
|
|
|
596 |
<th class ="PMPName">Name</th>
|
|
|
597 |
<th class="PMPAddress">Address</th>
|
|
|
598 |
<th class="PMPtelno">Mobile</th>
|
|
|
599 |
<th class="PMPpan">PAN</th>
|
|
|
600 |
<th class="PMPAdhaar">Aadhaar Number</th>
|
|
|
601 |
<th class="PMPemail">Email</th>
|
|
|
602 |
<th class="PMPownership">Share %</th>
|
|
|
603 |
</tr>
|
|
|
604 |
<tr>
|
| 22534 |
ashik.ali |
605 |
<td class="form-group"><input name="shareholderName4" type="text" size="25" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
606 |
<td class="form-group"><textarea name="shareholderAddress4" type="text" size="60"></textarea></td>
|
| 22534 |
ashik.ali |
607 |
<td class="form-group"><input name = "shareholderPhone4" type="text" pattern="[0-9]{10}" size="10" style="text-transform:uppercase;"></th>
|
|
|
608 |
<td class="form-group"><input name ="shareholderPan4" type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
|
|
|
609 |
<td class="form-group"><input name="shareholderAdhaar4" type="text" size="15" style="text-transform:uppercase;"></td>
|
|
|
610 |
<td class="form-group"><input name="shareholderEmail4" type="email" size="20" style="text-transform:uppercase;"></td>
|
|
|
611 |
<td class="form-group"><input name="shareholderOwner4" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
|
| 22095 |
kshitij.so |
612 |
|
|
|
613 |
</tr>
|
|
|
614 |
|
|
|
615 |
|
|
|
616 |
</table>
|
|
|
617 |
|
|
|
618 |
</div>
|
|
|
619 |
|
|
|
620 |
<h4 class="page-header">7. Store Manager Details</h4>
|
|
|
621 |
|
|
|
622 |
|
|
|
623 |
<div class="form-group">
|
|
|
624 |
<label for="">Name
|
|
|
625 |
<input type="text" name="managerName"placeholder="Name"></label>
|
|
|
626 |
<label for="">Mobile
|
| 22534 |
ashik.ali |
627 |
<input type="text" name="managerNo" pattern="[0-9]{10}" title="Please enter Valid Mobile number" placeholder="Mobile No" style="text-transform:uppercase;"> </label>
|
| 22095 |
kshitij.so |
628 |
<label for="">Email
|
| 22534 |
ashik.ali |
629 |
<input type="email" name="managerEmail"size="25px" placeholder="Emailid" style="text-transform:uppercase;"> </label>
|
| 22095 |
kshitij.so |
630 |
|
|
|
631 |
</div>
|
|
|
632 |
|
|
|
633 |
|
|
|
634 |
<h4 class="page-header">8. Manpower Details</h4>
|
|
|
635 |
|
|
|
636 |
<div class="form-group">
|
|
|
637 |
<label for="">Number of Employees
|
| 22534 |
ashik.ali |
638 |
<input type="text" pattern="[0-9]" name="noOfEmployees"placeholder="Number of Employees" style="text-transform:uppercase;"></label>
|
| 22095 |
kshitij.so |
639 |
<label for="">Number of Management Staff
|
| 22534 |
ashik.ali |
640 |
<input type="text" pattern="[0-9]" name="managementStaff" placeholder="Management Staff" style="text-transform:uppercase;"> </label>
|
| 22095 |
kshitij.so |
641 |
|
|
|
642 |
</div>
|
|
|
643 |
|
|
|
644 |
<h4 class="page-header">9. Experience In Telecom Trade/other Trade (Brand & Product Category)</h4>
|
|
|
645 |
<div class="bcontacts">
|
|
|
646 |
<textarea rows="4" name="experienceinTelecome"cols="50" placeholder="Describe yourself here..."></textarea>
|
|
|
647 |
</div>
|
|
|
648 |
|
|
|
649 |
<h4 class="page-header">10. Description of Existing Business & Annual Turnover</h4>
|
|
|
650 |
<div class="bcontacts">
|
|
|
651 |
<textarea rows="4" name="descriptionofExistingBusiness"cols="50" placeholder="Describe yourself here..."></textarea>
|
|
|
652 |
</div>
|
|
|
653 |
<p>Please Provide ITR of last Two years</p>
|
|
|
654 |
<div class = "form-group file upload">
|
|
|
655 |
<input type="file" accept="application/pdf,image/*" name ="doc_itrDoc">
|
|
|
656 |
<input type="hidden" name="itrDoc"/>
|
|
|
657 |
</div>
|
|
|
658 |
|
|
|
659 |
|
|
|
660 |
<h4 class="page-header">11.Business Model</h4>
|
|
|
661 |
|
|
|
662 |
<div class="btn-group">
|
|
|
663 |
<label class="btn btn-default">
|
|
|
664 |
<input type="radio" name="businessModel" value="Retailer" required>
|
|
|
665 |
<span>Retailer</span>
|
|
|
666 |
</label>
|
|
|
667 |
<label class="btn btn-default">
|
|
|
668 |
<input type="radio" name="businessModel" value="Distributor" required>
|
|
|
669 |
<span>Distributor</span>
|
|
|
670 |
</label>
|
|
|
671 |
<label class="btn btn-default">
|
|
|
672 |
<input type="radio" name="businessModel" value="Franchises" required>
|
|
|
673 |
<span>Franchise</span>
|
|
|
674 |
</label>
|
|
|
675 |
<label class="btn btn-default">
|
|
|
676 |
<input type="radio" name="businessModel" value="Other" required>
|
|
|
677 |
<span>Other</span>
|
|
|
678 |
</label>
|
|
|
679 |
</div>
|
|
|
680 |
|
|
|
681 |
|
|
|
682 |
<h4 class="page-header">12. Selling Online (if yes, please specify Portal Names)</h4>
|
|
|
683 |
|
|
|
684 |
<div class="btn-group">
|
|
|
685 |
<label class="btn btn-default">
|
|
|
686 |
<input type="radio" name="sellingOnline" value="yes">
|
|
|
687 |
<span>Yes</span>
|
|
|
688 |
</label>
|
|
|
689 |
<label class="btn btn-default">
|
|
|
690 |
<input type="radio" name="sellingOnline" value="no">
|
|
|
691 |
<span>No</span>
|
|
|
692 |
</label>
|
|
|
693 |
</div>
|
|
|
694 |
<div class="form-group portal Names" id = "sellingyes">
|
|
|
695 |
<label>Portal Names</label>
|
| 22534 |
ashik.ali |
696 |
<input type="text" name="portalName1" size="25" style="text-transform:uppercase;">
|
|
|
697 |
<input type="text" name="portalName2" size="25" style="text-transform:uppercase;">
|
|
|
698 |
<input type="text" name="portalName3" size="25" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
699 |
</div>
|
|
|
700 |
<h4 class="page-header">13. Area of Shop(in Sq Feet)</h4>
|
|
|
701 |
<div>
|
|
|
702 |
<div class="form-group">
|
|
|
703 |
<label>
|
|
|
704 |
|
|
|
705 |
<input type="number" name="east" placeholder="East(Sq Feet)">
|
|
|
706 |
<input type="number" name="west" placeholder="West(Sq Feet)">
|
|
|
707 |
<input type="number" name="north" placeholder="North(Sq Feet)">
|
|
|
708 |
</label>
|
|
|
709 |
</div>
|
|
|
710 |
<br>
|
|
|
711 |
<div class="form-group">
|
|
|
712 |
<label>
|
|
|
713 |
|
|
|
714 |
<input type="number" name="south" placeholder="South(Sq Feet)">
|
|
|
715 |
<input type="number" name="front" placeholder="Front(Sq Feet)">
|
|
|
716 |
<input type="number" name="roadSize" placeholder="Road Size in Front(Sq Feet)">
|
|
|
717 |
|
|
|
718 |
</label>
|
|
|
719 |
</div>
|
|
|
720 |
|
|
|
721 |
</div>
|
|
|
722 |
<div class="shopArea">
|
|
|
723 |
<div class="btn-group">
|
|
|
724 |
<label class="btn btn-default">
|
|
|
725 |
<input type="radio" name="shopArea" value="Singleside">
|
|
|
726 |
<span>Single Side</span>
|
|
|
727 |
</label>
|
|
|
728 |
<label class="btn btn-default">
|
|
|
729 |
<input type="radio" name="shopArea" value"Twoside">
|
|
|
730 |
<span>Two Side</span>
|
|
|
731 |
</label>
|
|
|
732 |
<label class="btn btn-default">
|
|
|
733 |
<input type="radio" name="shopArea" value="Corner">
|
|
|
734 |
<span>Corner</span>
|
|
|
735 |
</label>
|
|
|
736 |
</div>
|
|
|
737 |
</div>
|
|
|
738 |
|
|
|
739 |
|
|
|
740 |
<h4 class="page-header">14. Status of Shop</h4>
|
|
|
741 |
|
|
|
742 |
<div class="btn-group">
|
|
|
743 |
<label class="btn btn-default">
|
|
|
744 |
<input type="radio" name="shopStatus" value="semifurnished">
|
|
|
745 |
<span>Semi Furnished</span>
|
|
|
746 |
</label>
|
|
|
747 |
<label class="btn btn-default">
|
|
|
748 |
<input type="radio" name="shopStatus" value="fullfurnished">
|
|
|
749 |
<span>Fully Furnished</span>
|
|
|
750 |
</label>
|
|
|
751 |
</div>
|
|
|
752 |
|
|
|
753 |
<div class="checkboxes status" id ="shopsemifurnished">
|
|
|
754 |
<div class="btn btn-default">
|
|
|
755 |
<label for="success1" class="btn btn-success">Flooring<input type="checkbox" name="flooring"
|
|
|
756 |
value ="flooring" id="success1" class="badgebox"><span class="badge">✓</span></label>
|
|
|
757 |
<label for="warning1" class="btn btn-success">Ceiling<input type="checkbox" name="cieling" value="ceiling" id="warning1" class="badgebox"><span class="badge">✓</span></label>
|
|
|
758 |
|
|
|
759 |
|
|
|
760 |
</div>
|
|
|
761 |
</div>
|
|
|
762 |
|
|
|
763 |
<div class ="checkboxes status" id ="shopfullfurnished">
|
|
|
764 |
<div class="row text-center">
|
|
|
765 |
<label for="default" class="btn btn-success">Store <input type="checkbox" name="store" value="yes" id="default" class="badgebox"><span class="badge">✓</span></label>
|
|
|
766 |
<label for="primary" class="btn btn-success">Washroom <input type="checkbox" name="washroom" value="yes" id="primary" class="badgebox"><span class="badge">✓</span></label>
|
|
|
767 |
<label for="info" class="btn btn-success">Water Supply<input type="checkbox" name="waterSupply" value="yes" id="info" class="badgebox"><span class="badge">✓</span></label>
|
|
|
768 |
<label for="success" class="btn btn-success">Electricity<input type="checkbox" name="electricity"
|
|
|
769 |
value ="yes" id="success" class="badgebox"><span class="badge">✓</span></label>
|
|
|
770 |
<label for="warning" class="btn btn-success">Pantry<input type="checkbox" name="pantry" value="yes" id="warning" class="badgebox"><span class="badge">✓</span></label>
|
|
|
771 |
</div>
|
|
|
772 |
</div>
|
|
|
773 |
|
|
|
774 |
|
|
|
775 |
<h4 class="page-header">15. Shop Available At</h4>
|
|
|
776 |
|
|
|
777 |
<div class="btn-group">
|
|
|
778 |
<label class="btn btn-default">
|
|
|
779 |
<input type="radio" name="shopAvailbility" value="Basement">
|
|
|
780 |
<span>Basement</span>
|
|
|
781 |
</label>
|
|
|
782 |
<label class="btn btn-default">
|
|
|
783 |
<input type="radio" name="shopAvailbility" value="Groundfloor">
|
|
|
784 |
<span>Ground Floor</span>
|
|
|
785 |
</label>
|
|
|
786 |
<label class="btn btn-default">
|
|
|
787 |
<input type="radio" name="shopAvailbility" value="firstfloor">
|
|
|
788 |
<span>First Floor</span>
|
|
|
789 |
</label>
|
|
|
790 |
|
|
|
791 |
<label class="btn btn-default">
|
|
|
792 |
<input type="radio" name="shopAvailbility" value="secondfloor">
|
|
|
793 |
<span>Second Floor</span>
|
|
|
794 |
</label>
|
|
|
795 |
|
|
|
796 |
<label class="btn btn-default">
|
|
|
797 |
<input type="radio" name="shopAvailbility" value="thirdfloor">
|
|
|
798 |
<span>Third Floor</span>
|
|
|
799 |
</label>
|
|
|
800 |
</div>
|
|
|
801 |
|
|
|
802 |
<div class="form-group bdetail">
|
|
|
803 |
<p>Provide pictures of the shop from 3 different angles, ceiling and flooring</p>
|
|
|
804 |
<input type="file" name="doc_angleDoc1" accept="application/pdf,image/*" >
|
|
|
805 |
<input type="hidden" name="angleDoc1"/>
|
|
|
806 |
<input type="file" name="doc_angleDoc2" accept="application/pdf,image/*" >
|
|
|
807 |
<input type="hidden" name="angleDoc2"/>
|
|
|
808 |
<input type="file" name="doc_angleDoc3" accept="application/pdf,image/*" >
|
|
|
809 |
<input type="hidden" name="angleDoc3"/>
|
|
|
810 |
<input type="file" name="doc_angleDoc4" accept="application/pdf,image/*" >
|
|
|
811 |
<input type="hidden" name="angleDoc4"/>
|
|
|
812 |
<input type="file" name="doc_angleDoc5" accept="application/pdf,image/*">
|
|
|
813 |
<input type="hidden" name="angleDoc5"/>
|
|
|
814 |
</div>
|
|
|
815 |
|
|
|
816 |
<h4 class="page-header">16. Location of Shop</h4>
|
|
|
817 |
<div class="btn-group">
|
|
|
818 |
<label class="btn btn-default">
|
|
|
819 |
<input type="radio" name="location" value="shoppingMall">
|
|
|
820 |
<span>Shopping Mall</span>
|
|
|
821 |
</label>
|
|
|
822 |
<label class="btn btn-default">
|
|
|
823 |
<input type="radio" name="location" value="MainMobileMarket">
|
|
|
824 |
<span>Main Mobile Market</span>
|
|
|
825 |
</label>
|
|
|
826 |
<label class="btn btn-default">
|
|
|
827 |
<input type="radio" name="location" value="LocalMarket">
|
|
|
828 |
<span>Local Market</span>
|
|
|
829 |
</label>
|
|
|
830 |
|
|
|
831 |
</div>
|
|
|
832 |
|
|
|
833 |
|
|
|
834 |
|
|
|
835 |
<h4 class="page-header">17.Nearest Mobile Store</h4>
|
|
|
836 |
<div class="btn-group">
|
|
|
837 |
<label class="btn btn-default">
|
|
|
838 |
<input type="radio" name="nearestStore" value="100mtrs">
|
|
|
839 |
<span>100Mtrs</span>
|
|
|
840 |
</label>
|
|
|
841 |
<label class="btn btn-default">
|
|
|
842 |
<input type="radio" name="nearestStore" value="200mtrs">
|
|
|
843 |
<span>200Mtrs</span>
|
|
|
844 |
</label>
|
|
|
845 |
<label class="btn btn-default">
|
|
|
846 |
<input type="radio" name="nearestStore" value="500mtrs">
|
|
|
847 |
<span>500Mtrs</span>
|
|
|
848 |
</label>
|
|
|
849 |
|
|
|
850 |
</div>
|
|
|
851 |
|
|
|
852 |
<div class="form-group location">
|
|
|
853 |
<label>Name of the Shop</label>
|
| 22534 |
ashik.ali |
854 |
<input type="text" size ="35" name="storeName" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
855 |
<br>
|
|
|
856 |
<br>
|
|
|
857 |
<label>Address of the Shop</label>
|
| 22534 |
ashik.ali |
858 |
<input type="text" size ="65" name="storeAddress" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
859 |
</div>
|
|
|
860 |
|
|
|
861 |
|
|
|
862 |
|
|
|
863 |
<h4 class="page-header">18. Ownership of Shop</h4>
|
|
|
864 |
|
|
|
865 |
<div class="btn-group">
|
|
|
866 |
<label class="btn btn-default">
|
|
|
867 |
<input type="radio" name="ownership" value="Selfowned">
|
|
|
868 |
<span>Self Owned</span>
|
|
|
869 |
</label>
|
|
|
870 |
<label class="btn btn-default">
|
|
|
871 |
<input type="radio" name="ownership" value="Rented">
|
|
|
872 |
<span>Rented</span>
|
|
|
873 |
</label>
|
|
|
874 |
<label class="btn btn-default">
|
|
|
875 |
<input type="radio" name="ownership" value="lease">
|
|
|
876 |
<span>Lease</span>
|
|
|
877 |
</label>
|
|
|
878 |
</label>
|
|
|
879 |
<label class="btn btn-default">
|
|
|
880 |
<input type="radio" name="ownership" value="collaboration">
|
|
|
881 |
<span>Collaboration</span>
|
|
|
882 |
</label>
|
|
|
883 |
|
|
|
884 |
</div>
|
|
|
885 |
|
|
|
886 |
<div class="form-group bdetail">
|
|
|
887 |
<p>Provide relevant documents (Electricity bill/Rent Agreement/Lease Deed)to prove the status of ownership</p>
|
|
|
888 |
<input type="file" accept="application/pdf,image/*" name="doc_ownershipDoc">
|
|
|
889 |
<input type="hidden" name="ownershipDoc"/>
|
|
|
890 |
</div>
|
|
|
891 |
|
|
|
892 |
|
|
|
893 |
<h4 class="page-header">19. Insurance of Shop (if yes, please provide the copy of the same)</h4>
|
|
|
894 |
|
|
|
895 |
|
|
|
896 |
<div class="btn-group">
|
|
|
897 |
<label class="btn btn-default">
|
|
|
898 |
<input type="radio" name="insurance" value="yes">
|
|
|
899 |
<span>Yes</span>
|
|
|
900 |
</label>
|
|
|
901 |
<label class="btn btn-default">
|
|
|
902 |
<input type="radio" name="insurance" value="no">
|
|
|
903 |
<span>No</span>
|
|
|
904 |
</label>
|
|
|
905 |
</div>
|
|
|
906 |
|
|
|
907 |
<div class="form-group insurance doc" id= "docyes">
|
|
|
908 |
<p>Please provide copy of insurance document</p>
|
|
|
909 |
<input type="file" accept="application/pdf,image/*" name="doc_insuranceDoc">
|
|
|
910 |
<input type="hidden" name="insuranceDoc"/>
|
|
|
911 |
</div>
|
|
|
912 |
|
|
|
913 |
|
|
|
914 |
<h4 class="page-header">20. Loan on Shop (LAP/BL/CC/others)</h4>
|
|
|
915 |
|
|
|
916 |
<div class="btn-group">
|
|
|
917 |
<label class="btn btn-default">
|
|
|
918 |
<input type="radio" name="loan" value="yes">
|
|
|
919 |
<span>Yes</span>
|
|
|
920 |
</label>
|
|
|
921 |
<label class="btn btn-default">
|
|
|
922 |
<input type="radio" name="loan" value="no">
|
|
|
923 |
<span>No</span>
|
|
|
924 |
</label>
|
|
|
925 |
</div>
|
|
|
926 |
|
|
|
927 |
<div class="form-group loan document" id ="documentyes">
|
|
|
928 |
<p>Please provide current statement Letter</p>
|
|
|
929 |
<input type="file" accept="application/pdf,image/*" name="doc_loanDoc">
|
|
|
930 |
<input type="hidden" name="loanDoc"/>
|
|
|
931 |
<p>Please provide current sanction Letter</p>
|
|
|
932 |
<input type="file" accept="application/pdf,image/*" name="doc_sanctionDoc">
|
|
|
933 |
<input type="hidden" name="sanctionDoc"/>
|
|
|
934 |
</div>
|
|
|
935 |
|
|
|
936 |
|
|
|
937 |
<h4 class="page-header">21. Bank Name & Address</h4>
|
|
|
938 |
|
|
|
939 |
<div class="form-group float-label-control">
|
|
|
940 |
<label for="">Account Number</label>
|
| 22534 |
ashik.ali |
941 |
<input type="text" name="accountNumber"class="form-control" placeholder="Account Number" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
942 |
</div>
|
|
|
943 |
<div class="form-group float-label-control">
|
|
|
944 |
<label for="">Bank Name</label>
|
| 22534 |
ashik.ali |
945 |
<input type="text" name="bankName"class="form-control" placeholder="Bank Name" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
946 |
</div>
|
|
|
947 |
<div class="form-group float-label-control">
|
|
|
948 |
<label for="">IFSC Code</label>
|
| 22534 |
ashik.ali |
949 |
<input type="text" name="ifscCode"class="form-control" placeholder="IFSC Code" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
950 |
</div>
|
|
|
951 |
<div class="form-group float-label-control">
|
|
|
952 |
<label for="">Branch Name</label>
|
| 22534 |
ashik.ali |
953 |
<input type="text" name="branchName" class="form-control" placeholder="Branch Name" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
954 |
</div>
|
|
|
955 |
<div >
|
|
|
956 |
<p>Please attach the copy of cancelled cheque</p>
|
|
|
957 |
<div class="form-group">
|
|
|
958 |
<input type="file" name="doc_chequeCopy" accept="application/pdf,image/*">
|
|
|
959 |
<input type="hidden" name="chequeCopy"/>
|
|
|
960 |
</div>
|
|
|
961 |
|
|
|
962 |
|
|
|
963 |
<h4 class="page-header">22. HSPS Bank Account Detail</h4>
|
|
|
964 |
|
|
|
965 |
<p>Please deposit amount of <strong> Rs 1 Lac </strong>as advance payment in following account through NEFT and submit the UTR No.</p>
|
|
|
966 |
<div class="form-group float-label-control">
|
|
|
967 |
<label for="">UTR Number</label>
|
| 22534 |
ashik.ali |
968 |
<input type="text" name="utr" class="form-control" placeholder="UTR No" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
969 |
</div>
|
|
|
970 |
<p><b>Note:</b> Advance amount deposited shall be adjustable in the first billing. This amount is 100% refundable in case of withdrawal of application by applicant.</p>
|
|
|
971 |
|
|
|
972 |
|
|
|
973 |
|
|
|
974 |
<div class ="Account">
|
|
|
975 |
<label>Account Name: New Spice Solutions Pvt Ltd</label><br>
|
|
|
976 |
<label>Bank Name: IndusInd Bank Ltd.</label><br>
|
|
|
977 |
<label>Account No.:201000488351</label><br>
|
|
|
978 |
<label>Branch:M-56, Greater Kailash-II, Main Market New Delhi-110048</label><br>
|
|
|
979 |
<label>IFSC:INDB0000012</label><br>
|
|
|
980 |
</div>
|
|
|
981 |
|
|
|
982 |
<div class="submit">
|
|
|
983 |
<button type="submit" class="btn btn-success btn-lg">Submit</button>
|
|
|
984 |
</div>
|
|
|
985 |
|
|
|
986 |
<div class="alert alert-success" role="alert" id="success_message">Success <i class="glyphicon glyphicon-thumbs-up"></i> Thanks for contacting us, we will get back to you shortly.</div>
|
|
|
987 |
|
|
|
988 |
|
|
|
989 |
|
|
|
990 |
|
|
|
991 |
<!-- <fieldset hidden disabled="disabled">
|
|
|
992 |
<h4 class="page-header">PMP STORE REGISTRATION APPROVAL</h4>
|
|
|
993 |
<p>(FOR OFFICE USE ONLY)</P>
|
|
|
994 |
|
|
|
995 |
<div class=breg>
|
|
|
996 |
<div class=bApproval>
|
|
|
997 |
|
|
|
998 |
<label>Recommended by</label>
|
| 22534 |
ashik.ali |
999 |
<input type="text" name = "recommended"class="reg-control" size="50" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
1000 |
|
|
|
1001 |
</div>
|
|
|
1002 |
<br>
|
|
|
1003 |
|
|
|
1004 |
<div class=bApproval>
|
|
|
1005 |
<label>Business Manager</label>
|
| 22534 |
ashik.ali |
1006 |
<input type="text" name=" bManager" class="reg-control" size="50" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
1007 |
</div>
|
|
|
1008 |
<br>
|
|
|
1009 |
<div class=bApproval>
|
|
|
1010 |
<label>Operations Manager</label>
|
| 22534 |
ashik.ali |
1011 |
<input type="text"name="operation"class="reg-control" size="50" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
1012 |
</div>
|
|
|
1013 |
<br>
|
|
|
1014 |
<div class=bApproval>
|
|
|
1015 |
<label>BusinessHeadCategoryHead</label>
|
| 22534 |
ashik.ali |
1016 |
<input type="text" name="bhead"class="reg-control" size="50" style="text-transform:uppercase;">
|
| 22095 |
kshitij.so |
1017 |
</div>
|
|
|
1018 |
|
|
|
1019 |
|
|
|
1020 |
</div>
|
|
|
1021 |
</fieldset> -->
|
|
|
1022 |
|
|
|
1023 |
</form>
|
|
|
1024 |
</div>
|
|
|
1025 |
</div>
|
|
|
1026 |
<div class="col-sm-4">
|
|
|
1027 |
<div class="panel panel-default">
|
|
|
1028 |
|
|
|
1029 |
<div class="panel-body">
|
|
|
1030 |
|
|
|
1031 |
|
|
|
1032 |
<label>Spice Global Knowledge Park - 6th Floor, Plot No.19A & 19B, Sector 125, Noida, UP - 201301</label>
|
|
|
1033 |
<br>
|
|
|
1034 |
<label>Email - care@profitmandi.com</<label>
|
|
|
1035 |
<br>
|
|
|
1036 |
<label>Contact - 8588842949 </label>
|
|
|
1037 |
</div>
|
|
|
1038 |
</div>
|
|
|
1039 |
</div>
|
|
|
1040 |
|
|
|
1041 |
</div>
|
|
|
1042 |
|
|
|
1043 |
</div>
|
|
|
1044 |
</div>
|
|
|
1045 |
</body>
|
|
|
1046 |
</html>
|