Subversion Repositories SmartDukaan

Rev

Rev 22617 | Go to most recent revision | Details | Compare with Previous | Last modification | View Log | RSS feed

Rev Author Line No. Line
22095 kshitij.so 1
<html>
2
<head>
3
 
22192 amit.gupta 4
<script src="${rc.contextPath}/resources/fofo-form/js/jquery-1.10.2.min.js"></script>
5
<link rel="stylesheet" href="${rc.contextPath}/resources/fofo-form/css/bootstrap.min.css"/>
6
<link rel="stylesheet" type="text/css" href="${rc.contextPath}/resources/fofo-form/css/main.css"/>
22095 kshitij.so 7
<!-- Optional theme -->
22192 amit.gupta 8
<link rel="stylesheet" href="${rc.contextPath}/resources/fofo-form/css/bootstrap-theme.min.css" />
22095 kshitij.so 9
 
10
<!-- Latest compiled and minified JavaScript -->
22192 amit.gupta 11
<script src="${rc.contextPath}/resources/fofo-form/js/bootstrap.min.js"></script>
12
<script src="${rc.contextPath}/resources/fofo-form/js/bootstrapValidator.js"></script>
13
<script src="${rc.contextPath}/resources/fofo-form/js/reg.js"></script>
14
<script src="${rc.contextPath}/resources/fofo-form/js/reqformvalidator.js"></script>
15
<script src="${rc.contextPath}/resources/fofo-form/js/fofoedit.js"></script>
16
<script src="${rc.contextPath}/resources/fofo-form/js/jquery.blockUI.js"></script>
22095 kshitij.so 17
<script type="text/javascript">
22619 ashik.ali 18
contextPath = "${rc.contextPath}";
22194 amit.gupta 19
var jsonObj= $fofoForm;
22095 kshitij.so 20
 $(document).ready(function(){
22191 amit.gupta 21
	readForm();
22095 kshitij.so 22
    $("input[name$='bEntity']").click(function() {
23
        var test1 = $(this).val();
24
       $(".box").hide();
25
       $('input[name=dinNumber]').each(function(){
26
         $(this).prop('disabled', true);
27
      });
28
 
29
       var dinNumberInput = $("#sale"+test1+ " input[name=dinNumber]");
30
       if (dinNumberInput.prop('disabled') == true){
31
            dinNumberInput.prop('disabled', false);
32
       } 
33
        $("#sale" + test1).show();
34
});
35
});
36
</script>
37
 
38
<script type="text/javascript">
39
$(document).ready(function(){
40
    $("input[name$='bPmpDetail']").click(function() {
41
        var test1 = $(this).val();
42
       $(".pmp").hide();
43
        $("#Pmp" + test1).show();
44
    });
45
});
46
 
47
</script>
48
 
49
<script type="text/javascript">
50
$(document).ready(function(){
51
    $("input[name$='shopStatus']").click(function() {
52
        var test1 = $(this).val();
53
          $("#shopsemifurnished, #shopfullfurnished").find("input[type=checkbox]").each(function(){
54
         $(this).prop('disabled', true);
55
    });
56
 
57
       $(".status").hide();
58
       $("#shop" + test1).show();
59
       $("#shop" + test1).find("input[type=checkbox]").prop('disabled', false);
60
 
61
 
62
 
63
 
64
    });
65
});
66
 
67
</script>
68
<script type="text/javascript">
69
$(document).ready(function(){
70
    $("input[name$='sellingOnline']").click(function() {
71
        var test1 = $(this).val();
72
       $(".Names").hide();
73
        $("#selling" + test1).show();
74
    });
75
});
76
 
77
</script>
78
 
79
 
80
<script type="text/javascript">
81
$(document).ready(function(){
82
    associateValidator();
83
    $("input[name$='insurance']").click(function() {
84
        var test1 = $(this).val();
85
       $(".doc").hide();
86
        $("#doc" + test1).show();
87
    });
88
});
89
 
90
</script>
91
 
92
<script type="text/javascript">
22155 amit.gupta 93
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'];
22095 kshitij.so 94
$(document).ready(function(){
95
    $("input[name$='loan']").click(function() {
96
        var test1 = $(this).val();
97
       $(".document").hide();
98
        $("#document" + test1).show();
99
        $("#showHide").show();
100
    });
101
 
102
  docsArray.forEach(function(inputName){
103
 
104
	   $('input[name="' + inputName + '"]').change(function(e){
105
	    var formData = new FormData();
106
	    that = this;
107
		formData.append("file", $(this)[0].files[0]);
108
		jQuery.ajax({
22617 ashik.ali 109
	          url: "http://" + window.location.hostname + ":8080/profitmandi-web/document-upload",
22095 kshitij.so 110
	          type: 'POST',
111
	          data: formData,
112
	          	cache: false,
113
            contentType: false,
114
            processData: false,
115
	           success: function (data) {
116
	           console.log(data);
117
	           	hiddenInput = inputName.split("_")[1];
118
	           	var doc_id = 0;
119
	           	if (data.response.document_id == 0){
120
	           		alert(data.response.message);
121
	           		return;
122
	           	}
123
	               $('input[name="' + hiddenInput + '"]').val(data.response.document_id);
22152 amit.gupta 124
	               validator.data('bootstrapValidator').revalidateField($('input[name="' + hiddenInput + '"]'));
22095 kshitij.so 125
	           }
126
	    });
22617 ashik.ali 127
	})
128
 
129
 
130
 
131
 
132
 
133
 
134
 
135
 
22095 kshitij.so 136
 
137
  });
138
});
139
 
140
function queryStringToJSON(queryString) {
141
  var pairs = queryString.split('&');
142
  var result = {};
143
  pairs.forEach(function(pair) {
144
    pair = pair.split('=');
145
    result[pair[0]] = decodeURIComponent(pair[1] || '');
146
 
147
  });
148
  return result;
149
}
150
 
22148 amit.gupta 151
/*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"}*/
22095 kshitij.so 152
 
153
function jQFormSerializeArrToJson(formSerializeArr){
154
 var jsonObj = {};
155
 jQuery.map( formSerializeArr, function( n, i ) {
156
     jsonObj[n.name] = n.value;
157
 });
158
 return jsonObj;
159
}
160
 
161
</script>
162
 
163
<style>
164
.loading-image {
165
position: fixed;
166
top: 50%;
167
left: 50%;
168
margin-top: -50px;
169
margin-left: -100px;
170
z-index: 100;
171
}
172
</style>
173
 
174
</head>
175
 
176
<body>
177
<div class="container">
178
    <div class="row">
179
         <div class ="header">   
180
		 <h3 class="header">HOTSPOT PARTNER STORE</h3>
181
         <h4 class="header">Powered by Profit Mandi (A Unit of Spice Group)</h4>
182
         </div>
183
 
184
        <div class="header">
185
            <h5 class="header">APPLICATION FOR REGISTRATION</h5>
186
       </div>  
187
        <hr />
188
 
189
        <div class="row">
190
            <div class="col-sm-8">
191
 
192
                <form role="form" name="myform" id ="form"  enctype="multipart/form-data"  data-toggle="validator" novalidate>
22195 amit.gupta 193
                <input type="hidden" name="_id" value="0"/>
22095 kshitij.so 194
             <h4 class="page-header">1. Registered Business Name of HSPS (in Block Letters)</h4>
195
                     <div class="form-group ">
196
 
197
                     <label for=""></label>
22534 ashik.ali 198
                     <input type="text" name="registeredBusinessName" id="demo" class="bform" placeholder="Business Name"  style="text-transform:uppercase;"/>
22095 kshitij.so 199
                     </div>
200
 
201
 
202
             <h4 class="page-header">2. Registered Address (In Block Letters)</h4>
203
 
204
                    <div class="form-group float-label-control">
205
                        <label for="">Line 1</label>
22534 ashik.ali 206
                        <input type="text" name ="line1" class="form-control" placeholder="Line 1" style="text-transform:uppercase;">
22095 kshitij.so 207
                    </div>
208
                     <div class="form-group float-label-control">
209
                        <label for="">Line 2</label>
22534 ashik.ali 210
                        <input type="text" name ="line2"class="form-control" placeholder="Line 2" style="text-transform:uppercase;">
22095 kshitij.so 211
                    </div>
212
                     <div class="form-group float-label-control">
213
                        <label for="">Line 3</label>
22534 ashik.ali 214
                        <input type="text" name="line3" class="form-control" placeholder="Line 3" style="text-transform:uppercase;">
22095 kshitij.so 215
                    </div>
216
                     <div class="form-group float-label-control">
217
                        <label for="">City</label>
22534 ashik.ali 218
                        <input type="text" name="city" class="form-control" placeholder="City" style="text-transform:uppercase;">
22095 kshitij.so 219
                    </div>
220
                      <div class="form-group float-label-control">
221
                        <label for="">District</label>
22534 ashik.ali 222
                        <input type="text" name="district" class="form-control" placeholder="District" style="text-transform:uppercase;">
22095 kshitij.so 223
                    </div>
224
                     <div class="form-group float-label-control">
225
                        <label for="">Pincode</label>
22534 ashik.ali 226
                        <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;">
22095 kshitij.so 227
                      </div>  
228
 
229
                     <div class="form-group float-label-control">
230
 
231
                      <select class="form-control" name = "state" placeholder="State">
232
                       <option value=" ">State</option>
233
                     <option value="Andaman and Nicobar Islands">Andaman and Nicobar Islands</option>
234
                            <option value="Andhra Pradesh">Andhra Pradesh</option>
235
                            <option value="Arunachal Pradesh">Arunachal Pradesh</option>
236
                            <option value="Assam">Assam</option>
237
                            <option value="Bihar">Bihar</option>
238
                            <option value="Chandigarh">Chandigarh</option>
239
                            <option value="Chhattisgarh">Chhattisgarh</option>
240
                            <option value="Dadra and Nagar Haveli">Dadra and Nagar Haveli</option>
241
                            <option value="Daman and Diu">Daman and Diu</option>
242
                            <option value="Delhi">Delhi</option>
243
                            <option value="Goa">Goa</option>
244
                            <option value="Gujarat">Gujarat</option>
245
                            <option value="Haryana">Haryana</option>
246
                            <option value="Himachal Pradesh">Himachal Pradesh</option>
247
                            <option value="Jammu and Kashmir">Jammu and Kashmir</option>
248
                            <option value="Jharkhand">Jharkhand</option>
249
                            <option value="Karnataka">Karnataka</option>
250
                            <option value="Kerala">Kerala</option>
251
                            <option value="Lakshadweep">Lakshadweep</option>
252
                            <option value="Madhya Pradesh">Madhya Pradesh</option>
253
                            <option value="Maharashtra">Maharashtra</option>
254
                            <option value="Manipur">Manipur</option>
255
                            <option value="Meghalaya">Meghalaya</option>
256
                            <option value="Mizoram">Mizoram</option>
257
                            <option value="Nagaland">Nagaland</option>
258
                            <option value="Orissa">Orissa</option>
259
                            <option value="Pondicherry">Pondicherry</option>
260
                            <option value="Punjab">Punjab</option>
261
                            <option value="Rajasthan">Rajasthan</option>
262
                            <option value="Sikkim">Sikkim</option>
263
                            <option value="Tamil Nadu">Tamil Nadu</option>
264
                            <option value="Tripura">Tripura</option>
265
                            <option value="Telangana">Telangana</option>
266
                            <option value="Uttaranchal">Uttaranchal</option>
267
                            <option value="Uttar Pradesh">Uttar Pradesh</option>
268
                            <option value="West Bengal">West Bengal</option>
269
                                              </select>
270
                    </div>
271
 
272
 
273
                      <div class="form-group float-label-control">
274
                        <label for="">Email1</label>
22534 ashik.ali 275
                        <input type="email" class="form-control" name="registeredEmail1" placeholder="Email1" readonly value="${email}" style="text-transform:uppercase;">
22095 kshitij.so 276
                      </div>  
277
                         <p>Example:- xyz<strong>.hsps@gmail.com</strong></p>
278
 
279
 
280
 
281
                        <div class="form-group float-label-control">
282
                        <label for="">Email2</label>
22534 ashik.ali 283
                        <input type="email" class="form-control" name="registeredEmail2" placeholder="Email2" style="text-transform:uppercase;">
22095 kshitij.so 284
                      </div> 
285
 
286
 
287
                       <div class="form-group float-label-control">
288
                        <label for="">Mobile</label>
22534 ashik.ali 289
                        <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;">
22095 kshitij.so 290
                      </div>  
291
 
292
                    <label>Landline</label>
293
                      <div class="form-group Pmpform">
22534 ashik.ali 294
                      <input type="text" name="stdcode" maxlength = "5" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="STDcode" style="text-transform:uppercase;"/> 
22095 kshitij.so 295
 
296
 
22534 ashik.ali 297
                      <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 298
                      </div>
299
 
300
 
301
 
302
             <h4 class="page-header">3. Type of Business Entity</h4>
303
 
304
                   <div class="funkyradio">
305
 
306
                    <div class="funkyradio-primary">
307
                        <input type="radio" name="bEntity" id="radio1" value="SaleProprietorship" required>
308
                        <label for="radio1">Proprietor</label>
309
                    </div>
310
                    <div class="funkyradio-primary">
311
                        <input type="radio" name="bEntity" id="radio2" value="Partnership" required>
312
                        <label for="radio2">Partnership</label>
313
                    </div>
314
                    <div class="funkyradio-primary">
315
                        <input type="radio" name="bEntity" id="radio3" value="PrivateLimitedCompany" required>
316
                        <label for="radio3">Private Limited company</label>
317
                    </div>
318
                    <div class="funkyradio-primary">
319
                        <input type="radio" name="bEntity" id="radio4" value="LimitedLiabilityPartnership" required>
320
                        <label for="radio4">Limited Liability Partnership</label>
321
                    </div>
322
                </div>
323
                  <div class ="Entity">
324
                    <div class="SaleProprietorship box" id ="saleSaleProprietorship">Upload <strong>Proprietership proof</strong></div>
325
                     <div class="partnership box" id="salePartnership">Upload <strong>Partnership Deed</strong></div>
326
                     </div>
327
                      <div class="limitedcompany box" id="salePrivateLimitedCompany">
328
                      <div class="form-group float-label-control">
329
                        <label for="">DIN Number</label>
22534 ashik.ali 330
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number" style="text-transform:uppercase;">
22095 kshitij.so 331
                    </div>Upload <strong>Incorporation certificate,Memorandum & Article of association</strong>
332
                      </div>
333
 
334
 
335
                      <div class="LimitedLiabilityPartnership box" id="saleLimitedLiabilityPartnership">
336
 
337
 
338
                           <div class="form-group float-label-control">
339
                        <label for="">DIN Number</label>
22534 ashik.ali 340
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number" style="text-transform:uppercase;">
22095 kshitij.so 341
                    </div>Upload <strong>Registration certificate & partnership Deed</strong>
342
                     </div>
343
 
344
                    <div class = "form-group file upload"> 
345
                   <input type="file" accept="application/pdf,image/*" id="doc" name ="doc_bEntityDoc">
346
 
347
                   <input type="hidden" name="bEntityDoc"/>
348
                    </div>
349
 
350
                     <h4 class="page-header">4. Goods And Services Tax Number(GST)</h4>
351
                    <div class="Pmpform">
352
 
353
                        <input type="text" name="gst" class="bform" placeholder="Goods And Services Tax Number"/>
354
                    </div>
355
                     <p>Provide Copy of GST document</p>
356
                    <div class = "file upload"> 
357
                   <input type="file"  accept="application/pdf,image/*" name ="doc_gstDoc">
358
                     <input type="hidden" name="gstDoc"/>
359
                    </div>
360
 
361
 
362
                     <h4 class="page-header">5. Permanent Account Number(PAN)</h4>
363
                    <div class="form-group ">
364
 
365
                     <label for=""></label>
22534 ashik.ali 366
                     <input type="text" name="pan" maxlength="10" class="bform" placeholder="Permanent Account Number" style="text-transform:uppercase;"/></div>
22095 kshitij.so 367
                     <p>Provide Copy of PAN </p>
368
 
369
                    <div class = "form-group file upload"> 
370
 
371
                   <input type="file" accept="application/pdf,image/*" name="doc_panDoc">
372
                     <input type="hidden" name="panDoc"/>
373
                    </div>
374
 
375
 
376
             <h4 class="page-header">6. Full Details Of Business Entity</h4>
377
 
378
                   <div class="funkyradio">
379
                    <div class="funkyradio-primary">
380
                        <input type="radio" name="bPmpDetail" id="business1" value="Proprietor" required>
381
                        <label for="business1">Proprietor</label>
382
                    </div>
383
                    <div class="funkyradio-primary">
384
                        <input type="radio" name="bPmpDetail" id="business2" value="Partners" required>
385
                        <label for="business2">Partners</label>
386
                    </div>
387
                    <div class="funkyradio-primary">
388
                        <input type="radio" name="bPmpDetail" id="business3" value="Directors" required>
389
                        <label for="business3">Directors</label>
390
                    </div>
391
                </div>
392
 
393
                <div class="tablecontainer">
394
   <table class="businessdetail">
395
              <tr> 
396
              <th class ="PMPName">Name</th>
397
              <th  class="PMPAddress">Address</th> 
398
              <th class="PMPtelno">Mobile</th>
399
              <th class="PMPpan">PAN</th>
400
              <th class="PMPAdhaar">Aadhaar Number</th>
401
              <th class="PMPemail">Email</th>
402
              <th class="PMPownership">Share %</th>
403
 
404
               </tr>
405
            <tr>
406
 
22534 ashik.ali 407
                   <td class="form-group"><input type="text" name="proprietorBusineesName"size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 408
                   <td class="form-group"><textarea row="3" name="proprietorAddress"></textarea></td>
22534 ashik.ali 409
                   <td class="form-group"><input type="text" name="proprietorPhone" maxlength="10" pattern="[0-9]{10}"size="10" style="text-transform:uppercase;"></th>
410
                   <td class="form-group"><input type="text" name="proprietorPan" maxlength="10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
411
                    <td class="form-group"><input type="text"  name= "proprietorAdhaar" size="15" style="text-transform:uppercase;"></td>
412
                   <td class="form-group"><input type="email"  name= "proprietorEmail" size="20" style="text-transform:uppercase;"></td>
413
                   <td class="form-group"><input type="text" pattern="[0-9]" name="proprietorOwner" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 414
 
415
                   </tr>
416
 
417
 
418
            </table>
419
 
420
            </div>
421
            <div class="Partners pmp" id= "PmpPartners">
422
            <table class="businessdetail">
423
 
424
             <tr> 
425
              <th class ="PMPName">Name</th>
426
              <th  class="PMPAddress">Address</th> 
427
              <th class="PMPtelno">Mobile</th>
428
              <th class="PMPpan">PAN</th>
429
              <th class="PMPAdhaar">Aadhaar Number</th>
430
              <th class="PMPemail">Email</th>
431
              <th class="PMPownership">Share %</th>
432
 
433
               </tr>
434
                <tr>
435
 
22534 ashik.ali 436
                   <td class="form-group"><input name="partnerName1"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 437
                   <td class="form-group"><textarea name="partnerAddress1" type="text" size="60"></textarea></td>
22534 ashik.ali 438
                   <td class="form-group"><input name = "partnerPhone1" pattern="[0-9]{10}"type="text" size="10" style="text-transform:uppercase;"></th>
439
                   <td class="form-group"><input  name ="partnerPan1"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
440
                    <td class="form-group"><input name="partnerAdhaar1" type="text"  size="15" style="text-transform:uppercase;"></td>
441
                   <td class="form-group"><input name="partnerEmail1" type="email"  size="20" style="text-transform:uppercase;"></td>
442
                   <td class="form-group"><input name="partnerOwner1" type="text"pattern="[0-9]"size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 443
 
444
                   </tr>
445
 
446
 
447
            </table>
448
 
449
                   <table class="businessdetail">
450
 
451
             <tr> 
452
              <th class ="PMPName">Name</th>
453
              <th  class="PMPAddress">Address</th> 
454
              <th class="PMPtelno">Mobile</th>
455
              <th class="PMPpan">PAN</th>
456
              <th class="PMPAdhaar">Aadhaar Number</th>
457
              <th class="PMPemail">Email</th>
458
              <th class="PMPownership">Share %</th>
459
 
460
               </tr>
461
              <tr>
462
 
22534 ashik.ali 463
                   <td class="form-group"><input name="partnerName2"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 464
                   <td class="form-group"><textarea name="partnerAddress2" type="text" size="60"></textarea></td>
22534 ashik.ali 465
                   <td class="form-group"><input name = "partnerPhone2" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
466
                   <td class="businesspan"><input  name ="partnerPan2"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
467
                   <td class="form-group"><input name="partnerAdhaar2" type="text" size="15" style="text-transform:uppercase;"></td>
468
                   <td class="form-group"><input name="partnerEmail2" type="email" size="20" style="text-transform:uppercase;"></td>
469
                   <td class="form-group"><input name="partnerOwner2" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 470
 
471
                   </tr>
472
 
473
            </table>
474
                   <table class="businessdetail">
475
             <tr> 
476
            <th class ="PMPName">Name</th>
477
              <th  class="PMPAddress">Address</th> 
478
              <th class="PMPtelno">Mobile</th>
479
              <th class="PMPpan">PAN</th>
480
              <th class="PMPAdhaar">Aadhaar Number</th>
481
              <th class="PMPemail">Email</th>
482
              <th class="PMPownership">Share %</th>
483
 
484
               </tr>
485
                 <tr>
486
 
22534 ashik.ali 487
                   <td class="form-group"><input name="partnerName3"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 488
                   <td class="form-group"><textarea name="partnerAddress3" type="text" size="60"></textarea></td>
22534 ashik.ali 489
                   <td class="form-group"><input name = "partnerPhone3" type="text"  maxlength = "10" pattern="[0-9]{10}"  size="10" style="text-transform:uppercase;"></th>
490
                   <td class="form-group"><input  name ="partnerPan3"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
491
                    <td class="form-group"><input name="partnerAdhaar3" type="text" size="15" style="text-transform:uppercase;"></td>
492
                   <td class="form-group"><input name="partnerEmail3"  type="email" size="20" style="text-transform:uppercase;"></td>
493
                   <td class="form-group"><input name="partnerOwner3" pattern="[0-9"  type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 494
 
495
                   </tr>
496
 
497
 
498
            </table>
499
 
500
 
501
 
502
           <table class="businessdetail">
503
       <tr> 
504
                <th class ="PMPName">Name</th>
505
              <th  class="PMPAddress">Address</th> 
506
              <th class="PMPtelno">Mobile</th>
507
              <th class="PMPpan">PAN</th>
508
              <th class="PMPAdhaar">Aadhaar Number</th>
509
              <th class="PMPemail">Email</th>
510
              <th class="PMPownership">Share %</th>
511
               </tr>
512
               <tr>
513
 
22534 ashik.ali 514
                   <td class="form-group"><input name="partnerName4"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 515
                   <td class="form-group"><textarea name="partnerAddress4" type="text" size="60"></textarea></td>
22534 ashik.ali 516
                   <td class="form-group"><input name = "partnerPhone4"  pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
517
                   <td class="form-group"><input  name ="partnerPan4"type="text" maxlength = "10"title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
518
                    <td class="form-group"><input name="partnerAdhaar4" type="text" size="15" style="text-transform:uppercase;"></td>
519
                   <td class="form-group"><input name="partnerEmail4" type="email" size="20" style="text-transform:uppercase;"></td>
520
                   <td class="form-group"><input name="partnerOwner4" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 521
 
522
                   </tr>
523
 
524
 
525
            </table>
526
 
527
            </div>
528
 
529
 
530
             <div class="Directors pmp" id= "PmpDirectors">
531
            <table class="businessdetail">
532
               <tr> 
533
               <th class ="PMPName">Name</th>
534
              <th  class="PMPAddress">Address</th> 
535
              <th class="PMPtelno">Mobile</th>
536
              <th class="PMPpan">PAN</th>
537
              <th class="PMPAdhaar">Aadhaar Number</th>
538
              <th class="PMPemail">Email</th>
539
              <th class="PMPownership">Share %</th>
540
 
541
               </tr>
542
               <tr>
22534 ashik.ali 543
                   <td class="form-group"><input name="shareholderName1"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 544
                   <td class="form-group"><textarea name="shareholderAddress1" type="text" size="60"></textarea></td>
22534 ashik.ali 545
                   <td class="form-group"><input name = "shareholderPhone1" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
546
                   <td class="form-group"><input  name ="shareholderPan1"type="text" maxlength = "10"  title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
547
                   <td class="form-group"><input name="shareholderAdhaar1" type="text" size="15" style="text-transform:uppercase;"></td>
548
                   <td class="form-group"><input name="shareholderEmail1" type="email" size="20" style="text-transform:uppercase;"></td>
549
                   <td class="form-group"><input name="shareholderOwner1" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 550
 
551
                   </tr>
552
 
553
 
554
            </table>
555
 
556
                   <table class="businessdetail">
557
          <tr> 
558
                <th class ="PMPName">Name</th>
559
              <th  class="PMPAddress">Address</th> 
560
              <th class="PMPtelno">Mobile</th>
561
              <th class="PMPpan">PAN</th>
562
              <th class="PMPAdhaar">Aadhaar Number</th>
563
              <th class="PMPemail">Email</th>
564
              <th class="PMPownership">Share %</th>
565
               </tr>
566
                 <tr>
22534 ashik.ali 567
                   <td class="form-group"><input name="shareholderName2"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 568
                   <td class="form-group"><textarea name="shareholderAddress2" type="text" size="60"></textarea></td>
22534 ashik.ali 569
                   <td class="form-group"><input name = "shareholderPhone2" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
570
                   <td class="form-group"><input  name ="shareholderPan2"type="text" maxlength = "10"  title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
571
                    <td class="form-group"><input name="shareholderAdhaar2" type="text" size="15" style="text-transform:uppercase;"></td>
572
                   <td class="form-group"><input name="shareholderEmail2"  type="email" size="20" style="text-transform:uppercase;"></td>
573
                   <td class="form-group"><input name="shareholderOwner2" pattern="[0-9]"  type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 574
 
575
                   </tr>
576
            </table>
577
 
578
                   <table class="businessdetail">
579
              <tr> 
580
                <th class ="PMPName">Name</th>
581
              <th  class="PMPAddress">Address</th> 
582
              <th class="PMPtelno">Mobile</th>
583
              <th class="PMPpan">PAN</th>
584
              <th class="PMPAdhaar">Aadhaar Number</th>
585
              <th class="PMPemail">Email</th>
586
              <th class="PMPownership">Share %</th>
587
 
588
               </tr>
589
                   <tr>
22534 ashik.ali 590
                   <td class="form-group"><input name="shareholderName3"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 591
                   <td class="form-group"><textarea name="shareholderAddress3" type="text" size="60"></textarea></td>
22534 ashik.ali 592
                   <td class="form-group"><input name = "shareholderPhone3" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
593
                   <td class="form-group"><input  name ="shareholderPan3" type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
594
                   <td class="form-group"><input name="shareholderAdhaar3" type="text" size="15" style="text-transform:uppercase;"></td>
595
                   <td class="form-group"><input name="shareholderEmail3" type="email" size="20" style="text-transform:uppercase;"></td>
596
                   <td class="form-group"><input name="shareholderOwner3" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 597
 
598
                   </tr>
599
 
600
            </table>
601
 
602
                   <table class="businessdetail">
603
             <tr> 
604
                <th class ="PMPName">Name</th>
605
              <th  class="PMPAddress">Address</th> 
606
              <th class="PMPtelno">Mobile</th>
607
              <th class="PMPpan">PAN</th>
608
              <th class="PMPAdhaar">Aadhaar Number</th>
609
              <th class="PMPemail">Email</th>
610
              <th class="PMPownership">Share %</th>
611
               </tr>
612
                     <tr>
22534 ashik.ali 613
                   <td class="form-group"><input name="shareholderName4" type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 614
                   <td class="form-group"><textarea name="shareholderAddress4" type="text" size="60"></textarea></td>
22534 ashik.ali 615
                   <td class="form-group"><input name = "shareholderPhone4" type="text" pattern="[0-9]{10}" size="10" style="text-transform:uppercase;"></th>
616
                   <td class="form-group"><input  name ="shareholderPan4" type="text" maxlength = "10"  title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
617
                    <td class="form-group"><input name="shareholderAdhaar4" type="text" size="15" style="text-transform:uppercase;"></td>
618
                   <td class="form-group"><input name="shareholderEmail4"  type="email" size="20" style="text-transform:uppercase;"></td>
619
                   <td class="form-group"><input name="shareholderOwner4" pattern="[0-9]"  type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 620
 
621
                   </tr>
622
 
623
 
624
            </table>
625
 
626
            </div>
627
 
628
         <h4 class="page-header">7. Store Manager Details</h4>
629
 
630
 
631
                    <div class="form-group">
632
                    <label for="">Name
633
                    <input type="text" name="managerName"placeholder="Name"></label>
634
                    <label for="">Mobile
22534 ashik.ali 635
                        <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 636
                    <label for="">Email
22534 ashik.ali 637
                        <input type="email" name="managerEmail"size="25px" placeholder="Emailid" style="text-transform:uppercase;"> </label>  
22095 kshitij.so 638
 
639
                    </div>
640
 
641
 
642
            <h4 class="page-header">8. Manpower Details</h4>
643
 
644
               <div class="form-group">
645
                    <label for="">Number of Employees
22534 ashik.ali 646
                    <input type="text" pattern="[0-9]" name="noOfEmployees"placeholder="Number of Employees" style="text-transform:uppercase;"></label>
22095 kshitij.so 647
                    <label for="">Number of Management Staff
22534 ashik.ali 648
                        <input type="text" pattern="[0-9]" name="managementStaff" placeholder="Management Staff" style="text-transform:uppercase;"> </label>  
22095 kshitij.so 649
 
650
                    </div>
651
 
652
              <h4 class="page-header">9. Experience In Telecom Trade/other Trade (Brand & Product Category)</h4>
653
                <div class="bcontacts">
654
                   <textarea rows="4" name="experienceinTelecome"cols="50" placeholder="Describe yourself here..."></textarea> 
655
                </div>
656
 
657
            <h4 class="page-header">10. Description of Existing Business & Annual Turnover</h4>
658
                <div class="bcontacts">
659
                      <textarea rows="4" name="descriptionofExistingBusiness"cols="50" placeholder="Describe yourself here..."></textarea>
660
                </div>
661
                <p>Please Provide ITR of last Two years</p>
662
                <div class = "form-group file upload"> 
663
                   <input type="file" accept="application/pdf,image/*" name ="doc_itrDoc">
664
                      <input type="hidden" name="itrDoc"/>
665
                    </div>
666
 
667
 
668
            <h4 class="page-header">11.Business Model</h4>
669
 
670
            <div class="btn-group">
671
                    <label class="btn btn-default">
672
                   <input type="radio" name="businessModel" value="Retailer" required>
673
                   <span>Retailer</span>
674
                  </label>
675
                <label class="btn btn-default">
676
                    <input type="radio" name="businessModel" value="Distributor" required>
677
                    <span>Distributor</span>
678
                </label>
679
                <label class="btn btn-default">
680
                    <input type="radio" name="businessModel" value="Franchises" required>
681
                    <span>Franchise</span>
682
                </label>
683
                  <label class="btn btn-default">
684
                    <input type="radio" name="businessModel" value="Other" required>
685
                    <span>Other</span>
686
                </label>
687
              </div>
688
 
689
 
690
          <h4 class="page-header">12. Selling Online (if yes, please specify Portal Names)</h4>
691
 
692
                    <div class="btn-group">
693
                    <label class="btn btn-default">
694
                   <input type="radio" name="sellingOnline" value="yes">
695
                   <span>Yes</span>
696
                  </label>
697
                <label class="btn btn-default">
698
                    <input type="radio" name="sellingOnline" value="no">
699
                    <span>No</span>
700
                </label>
701
              </div>
702
                   <div class="form-group portal Names" id = "sellingyes">
703
                   <label>Portal Names</label>
22534 ashik.ali 704
                       <input type="text" name="portalName1" size="25" style="text-transform:uppercase;">
705
                       <input type="text" name="portalName2" size="25" style="text-transform:uppercase;">
706
                       <input type="text" name="portalName3" size="25" style="text-transform:uppercase;">
22095 kshitij.so 707
                  </div>
708
            <h4 class="page-header">13. Area of Shop(in Sq Feet)</h4>
709
              <div>
710
                 <div class="form-group">
711
                    <label>
712
 
713
                    <input type="number" name="east"  placeholder="East(Sq Feet)">
714
                    <input type="number" name="west"  placeholder="West(Sq Feet)">
715
                    <input type="number" name="north" placeholder="North(Sq Feet)"> 
716
                    </label>
717
                </div>
718
                    <br>
719
                      <div class="form-group">
720
                    <label>
721
 
722
                    <input type="number" name="south" placeholder="South(Sq Feet)">
723
                    <input type="number" name="front" placeholder="Front(Sq Feet)">
724
                    <input type="number" name="roadSize" placeholder="Road Size in Front(Sq Feet)">
725
 
726
                    </label>
727
                </div>
728
 
729
                  </div>  
730
                  <div class="shopArea">
731
                   <div class="btn-group">
732
                    <label class="btn btn-default">
733
                   <input type="radio" name="shopArea" value="Singleside">
734
                   <span>Single Side</span>
735
                  </label>
736
                <label class="btn btn-default">
737
                    <input type="radio" name="shopArea" value"Twoside">
738
                    <span>Two Side</span>
739
                </label>
740
                  <label class="btn btn-default">
741
                    <input type="radio" name="shopArea" value="Corner">
742
                    <span>Corner</span>
743
                </label>
744
              </div>
745
              </div>
746
 
747
 
748
              <h4 class="page-header">14. Status of Shop</h4>
749
 
750
                 <div class="btn-group">
751
                    <label class="btn btn-default">
752
                   <input type="radio" name="shopStatus" value="semifurnished">
753
                   <span>Semi Furnished</span>
754
                  </label>
755
                <label class="btn btn-default">
756
                    <input type="radio" name="shopStatus" value="fullfurnished">
757
                    <span>Fully Furnished</span>
758
                </label>
759
                </div>
760
 
761
                 <div class="checkboxes status" id ="shopsemifurnished">
762
                 <div class="btn btn-default">
763
   <label for="success1" class="btn btn-success">Flooring<input type="checkbox" name="flooring" 
764
          value ="flooring" id="success1" class="badgebox"><span class="badge">&check;</span></label>
765
        <label for="warning1" class="btn btn-success">Ceiling<input type="checkbox" name="cieling" value="ceiling" id="warning1" class="badgebox"><span class="badge">&check;</span></label>
766
 
767
 
768
              </div>
769
            </div>
770
 
771
<div class ="checkboxes status"  id ="shopfullfurnished">
772
          <div class="row text-center">
773
    <label for="default" class="btn btn-success">Store <input type="checkbox" name="store" value="yes" id="default" class="badgebox"><span class="badge">&check;</span></label>
774
        <label for="primary" class="btn btn-success">Washroom <input type="checkbox" name="washroom" value="yes" id="primary" class="badgebox"><span class="badge">&check;</span></label>
775
        <label for="info" class="btn btn-success">Water Supply<input type="checkbox" name="waterSupply" value="yes" id="info" class="badgebox"><span class="badge">&check;</span></label>
776
        <label for="success" class="btn btn-success">Electricity<input type="checkbox" name="electricity" 
777
          value ="yes" id="success" class="badgebox"><span class="badge">&check;</span></label>
778
        <label for="warning" class="btn btn-success">Pantry<input type="checkbox" name="pantry" value="yes" id="warning" class="badgebox"><span class="badge">&check;</span></label>
779
  </div>
780
    </div>
781
 
782
 
783
              <h4 class="page-header">15. Shop Available At</h4>
784
 
785
                     <div class="btn-group">
786
                    <label class="btn btn-default">
787
                   <input type="radio" name="shopAvailbility" value="Basement">
788
                   <span>Basement</span>
789
                  </label>
790
                <label class="btn btn-default">
791
                    <input type="radio" name="shopAvailbility" value="Groundfloor">
792
                    <span>Ground Floor</span>
793
                </label>
794
                  <label class="btn btn-default">
795
                    <input type="radio" name="shopAvailbility" value="firstfloor">
796
                    <span>First Floor</span>
797
                </label>
798
 
799
                  <label class="btn btn-default">
800
                    <input type="radio" name="shopAvailbility" value="secondfloor">
801
                    <span>Second Floor</span>
802
                </label>
803
 
804
                 <label class="btn btn-default">
805
                    <input type="radio" name="shopAvailbility" value="thirdfloor">
806
                    <span>Third Floor</span>
807
                </label>
808
                </div>
809
 
810
                <div class="form-group bdetail">
811
                   <p>Provide pictures of the shop from 3 different angles, ceiling and flooring</p>
812
                      <input type="file" name="doc_angleDoc1" accept="application/pdf,image/*" >
813
                      <input type="hidden" name="angleDoc1"/>
814
                      <input type="file" name="doc_angleDoc2" accept="application/pdf,image/*" >
815
                      <input type="hidden" name="angleDoc2"/>
816
                      <input type="file" name="doc_angleDoc3"  accept="application/pdf,image/*" >
817
                      <input type="hidden" name="angleDoc3"/>
818
                      <input type="file" name="doc_angleDoc4"  accept="application/pdf,image/*" >
819
                      <input type="hidden" name="angleDoc4"/>
820
                      <input type="file" name="doc_angleDoc5" accept="application/pdf,image/*">
821
                      <input type="hidden" name="angleDoc5"/>
822
                  </div>
823
 
824
         <h4 class="page-header">16. Location of Shop</h4>
825
                        <div class="btn-group">
826
                    <label class="btn btn-default">
827
                   <input type="radio" name="location" value="shoppingMall">
828
                   <span>Shopping Mall</span>
829
                  </label>
830
                <label class="btn btn-default">
831
                    <input type="radio" name="location" value="MainMobileMarket">
832
                    <span>Main Mobile Market</span>
833
                </label>
834
                  <label class="btn btn-default">
835
                    <input type="radio" name="location" value="LocalMarket">
836
                    <span>Local Market</span>
837
                </label>
838
 
839
                </div>
840
 
841
 
842
 
843
             <h4 class="page-header">17.Nearest Mobile Store</h4>
844
                           <div class="btn-group">
845
                    <label class="btn btn-default">
846
                   <input type="radio" name="nearestStore" value="100mtrs">
847
                   <span>100Mtrs</span>
848
                  </label>
849
                <label class="btn btn-default">
850
                    <input type="radio" name="nearestStore" value="200mtrs">
851
                    <span>200Mtrs</span>
852
                </label>
853
                  <label class="btn btn-default">
854
                    <input type="radio" name="nearestStore" value="500mtrs">
855
                    <span>500Mtrs</span>
856
                </label>
857
 
858
                </div>
859
 
860
                 <div class="form-group location">
861
                   <label>Name of the Shop</label>
22534 ashik.ali 862
                       <input type="text" size ="35" name="storeName" style="text-transform:uppercase;">
22095 kshitij.so 863
                       <br>
864
                       <br>
865
                        <label>Address of the Shop</label>
22534 ashik.ali 866
                       <input type="text" size ="65" name="storeAddress" style="text-transform:uppercase;">
22095 kshitij.so 867
                  </div>
868
 
869
 
870
 
871
            <h4 class="page-header">18. Ownership of Shop</h4>
872
 
873
                    <div class="btn-group">
874
                    <label class="btn btn-default">
875
                   <input type="radio" name="ownership" value="Selfowned">
876
                   <span>Self Owned</span>
877
                  </label>
878
                <label class="btn btn-default">
879
                    <input type="radio" name="ownership" value="Rented">
880
                    <span>Rented</span>
881
                </label>
882
                  <label class="btn btn-default">
883
                    <input type="radio" name="ownership" value="lease">
884
                    <span>Lease</span>
885
                </label>
886
                  </label>
887
                  <label class="btn btn-default">
888
                    <input type="radio" name="ownership" value="collaboration">
889
                    <span>Collaboration</span>
890
                </label>
891
 
892
                </div>
893
 
894
                 <div class="form-group bdetail">
895
                   <p>Provide relevant documents (Electricity bill/Rent Agreement/Lease Deed)to prove the status of ownership</p>
896
                     <input type="file" accept="application/pdf,image/*" name="doc_ownershipDoc">
897
                     <input type="hidden" name="ownershipDoc"/>
898
                   </div>
899
 
900
 
901
           <h4 class="page-header">19. Insurance of Shop (if yes, please provide the copy of the same)</h4>
902
 
903
 
904
                    <div class="btn-group">
905
                    <label class="btn btn-default">
906
                   <input type="radio" name="insurance" value="yes">
907
                   <span>Yes</span>
908
                  </label>
909
                <label class="btn btn-default">
910
                    <input type="radio" name="insurance" value="no">
911
                    <span>No</span>
912
                </label>
913
              </div>
914
 
915
                 <div class="form-group insurance doc"  id= "docyes">
916
                  <p>Please provide copy of insurance document</p>
917
                     <input type="file" accept="application/pdf,image/*" name="doc_insuranceDoc">
918
                      <input type="hidden" name="insuranceDoc"/>
919
                   </div>
920
 
921
 
922
         <h4 class="page-header">20. Loan on Shop (LAP/BL/CC/others)</h4>
923
 
924
                     <div class="btn-group">
925
                    <label class="btn btn-default">
926
                   <input type="radio" name="loan" value="yes">
927
                   <span>Yes</span>
928
                  </label>
929
                <label class="btn btn-default">
930
                    <input type="radio" name="loan" value="no">
931
                    <span>No</span>
932
                </label>
933
              </div>
934
 
935
                 <div class="form-group loan document" id ="documentyes">
936
                  <p>Please provide current statement Letter</p>
937
                     <input type="file" accept="application/pdf,image/*" name="doc_loanDoc">
938
                     <input type="hidden" name="loanDoc"/>
939
                      <p>Please provide current sanction Letter</p>
940
                     <input type="file" accept="application/pdf,image/*" name="doc_sanctionDoc">
941
                     <input type="hidden" name="sanctionDoc"/>
942
                   </div>
943
 
944
 
945
            <h4 class="page-header">21. Bank Name & Address</h4>
946
 
947
                  <div class="form-group float-label-control">
948
                        <label for="">Account Number</label>
22534 ashik.ali 949
                        <input type="text" name="accountNumber"class="form-control" placeholder="Account Number" style="text-transform:uppercase;">
22095 kshitij.so 950
                    </div>
951
                     <div class="form-group float-label-control">
952
                        <label for="">Bank Name</label>
22534 ashik.ali 953
                        <input type="text" name="bankName"class="form-control" placeholder="Bank Name" style="text-transform:uppercase;">
22095 kshitij.so 954
                    </div>
955
                     <div class="form-group float-label-control">
956
                        <label for="">IFSC Code</label>
22534 ashik.ali 957
                        <input type="text" name="ifscCode"class="form-control" placeholder="IFSC Code" style="text-transform:uppercase;">
22095 kshitij.so 958
                    </div>
959
                     <div class="form-group float-label-control">
960
                        <label for="">Branch Name</label>
22534 ashik.ali 961
                        <input type="text" name="branchName" class="form-control" placeholder="Branch Name" style="text-transform:uppercase;">
22095 kshitij.so 962
                    </div>
963
                     <div >
964
                  <p>Please attach the copy of cancelled cheque</p>
965
                      <div class="form-group">
966
                     <input type="file" name="doc_chequeCopy" accept="application/pdf,image/*">
967
                     <input type="hidden" name="chequeCopy"/>
968
                   </div>
969
 
970
 
971
                  <h4 class="page-header">22. HSPS Bank Account Detail</h4> 
972
 
973
                  <p>Please deposit amount of <strong> Rs 1 Lac </strong>as advance payment in following account through NEFT and submit the UTR No.</p>
974
                    <div class="form-group float-label-control">
975
                        <label for="">UTR Number</label>
22534 ashik.ali 976
                        <input type="text" name="utr" class="form-control" placeholder="UTR No" style="text-transform:uppercase;">
22095 kshitij.so 977
                    </div>
978
                    <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>
979
 
980
 
981
 
982
                      <div class ="Account">
983
                      <label>Account Name: New Spice Solutions Pvt Ltd</label><br>
984
                       <label>Bank Name: IndusInd Bank Ltd.</label><br>
985
                        <label>Account No.:201000488351</label><br>
986
                        <label>Branch:M-56, Greater Kailash-II, Main Market New Delhi-110048</label><br>
987
                         <label>IFSC:INDB0000012</label><br>
988
                        </div>
989
 
990
                <div class="submit">
991
                    <button type="submit" class="btn btn-success btn-lg">Submit</button>
992
                </div>
993
 
994
                <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>
995
 
996
 
997
 
998
 
999
 <!--             <fieldset hidden disabled="disabled">
1000
              <h4 class="page-header">PMP STORE REGISTRATION APPROVAL</h4>
1001
                 <p>(FOR OFFICE USE ONLY)</P>
1002
 
1003
                <div class=breg>
1004
                 <div class=bApproval>
1005
 
1006
                  <label>Recommended by</label>
22534 ashik.ali 1007
                  <input type="text" name = "recommended"class="reg-control" size="50" style="text-transform:uppercase;">
22095 kshitij.so 1008
 
1009
                  </div>
1010
                  <br>
1011
 
1012
                    <div class=bApproval>
1013
                  <label>Business Manager</label>
22534 ashik.ali 1014
                  <input type="text" name=" bManager" class="reg-control" size="50" style="text-transform:uppercase;">
22095 kshitij.so 1015
                </div>
1016
                      <br>
1017
                        <div class=bApproval>
1018
                    <label>Operations Manager</label>
22534 ashik.ali 1019
                  <input type="text"name="operation"class="reg-control"  size="50" style="text-transform:uppercase;">
22095 kshitij.so 1020
                </div>
1021
                  <br>
1022
               <div class=bApproval>
1023
                     <label>BusinessHeadCategoryHead</label>
22534 ashik.ali 1024
                  <input type="text" name="bhead"class="reg-control" size="50" style="text-transform:uppercase;">
22095 kshitij.so 1025
                </div>
1026
 
1027
 
1028
                 </div>
1029
               </fieldset> -->
1030
 
1031
                      </form>
1032
                    </div>
1033
          </div>
1034
   <div class="col-sm-4">
1035
                <div class="panel panel-default">
1036
 
1037
                    <div class="panel-body">
1038
 
1039
 
1040
                   <label>Spice Global Knowledge Park - 6th Floor, Plot No.19A & 19B, Sector 125, Noida, UP - 201301</label>
1041
                   <br>
1042
                    <label>Email - care@profitmandi.com</<label>
1043
                    <br> 
1044
                    <label>Contact - 8588842949 </label>
1045
                    </div>
1046
                </div>
1047
            </div>
1048
 
1049
        </div>
1050
 
1051
    </div>
1052
    </div>
1053
</body>
1054
</html>