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Rev 21997 | Details | Compare with Previous | Last modification | View Log | RSS feed

Rev Author Line No. Line
21920 rajender 1
<html>
2
<head>
3
 
4
<script type="text/javascript" src="$action.getContextPath()/js/jquery-1.10.2.min.js"></script>
5
<link rel="stylesheet" href="$action.getContextPath()/css/bootstrap.min.css"/>
6
<link rel="stylesheet" type="text/css" href="$action.getContextPath()/css/main.css"/>
7
<!-- Optional theme -->
8
<link rel="stylesheet" href="$action.getContextPath()/css/bootstrap-theme.min.css" />
9
 
10
<!-- Latest compiled and minified JavaScript -->
11
<script src="$action.getContextPath()/js/bootstrap.min.js" type="script/javascript"></script>
12
<script src="$action.getContextPath()/js/bootstrapValidator.js"></script>
13
<script src="$action.getContextPath()/js/reg.js"></script>
14
<script src="$action.getContextPath()/js/reqformvalidator.js"></script>
15
<script src="$action.getContextPath()/js/fofoedit.js"></script>
21997 rajender 16
<script src="$action.getContextPath()/js/jquery.blockUI.js"></script>
21920 rajender 17
<script type="text/javascript">
18
var jsonObj=$action.fofoFormJson();
19
console.log(JSON.stringify(jsonObj));
20
$(document).ready(function(){
21
readForm();
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
</script>
65
<script type="text/javascript">
66
$(document).ready(function(){
67
    $("input[name$='sellingOnline']").click(function() {
68
        var test1 = $(this).val();
69
       $(".Names").hide();
70
        $("#selling" + test1).show();
71
    });
72
});
73
 
74
</script>
75
 
76
 
77
<script type="text/javascript">
78
$(document).ready(function(){
79
    associateValidator();
80
    $("input[name$='insurance']").click(function() {
81
        var test1 = $(this).val();
82
       $(".doc").hide();
83
        $("#doc" + test1).show();
84
    });
85
});
86
 
87
</script>
88
 
89
<script type="text/javascript">
90
$(document).ready(function(){
91
    $("input[name$='loan']").click(function() {
92
        var test1 = $(this).val();
93
       $(".document").hide();
94
        $("#document" + test1).show();
95
        $("#showHide").show();
96
    });
21997 rajender 97
 
98
    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'];
99
  docsArray.forEach(function(inputName){
100
 
101
	   $('input[name="' + inputName + '"]').change(function(e){
102
	    var formData = new FormData();
103
	    that = this;
104
		formData.append("file", $(this)[0].files[0]);
105
		jQuery.ajax({
106
	          url: "upload",
107
	          type: 'POST',
108
	          data: formData,
109
	            processData: false,
110
	           success: function (data) {
111
	           	hiddenInput = inputName.split("_")[1];
112
	               $('input[name="' + hiddenInput + '"]').val(data);
113
	               console.log(data);
114
	           }
115
	    });
116
	});
21920 rajender 117
});
21997 rajender 118
});
21920 rajender 119
 
120
function queryStringToJSON(queryString) {
121
  var pairs = queryString.split('&');
122
  var result = {};
123
  pairs.forEach(function(pair) {
124
    pair = pair.split('=');
125
    result[pair[0]] = decodeURIComponent(pair[1] || '');
126
 
127
  });
128
  return result;
129
}
130
 
131
 
132
function jQFormSerializeArrToJson(formSerializeArr){
133
 var jsonObj = {};
134
 jQuery.map( formSerializeArr, function( n, i ) {
135
     jsonObj[n.name] = n.value;
136
 });
137
 return jsonObj;
138
}
139
 
140
</script>
141
 
142
<style>
143
.loading-image {
144
position: fixed;
145
top: 50%;
146
left: 50%;
147
margin-top: -50px;
148
margin-left: -100px;
149
z-index: 100;
150
}
151
</style>
152
 
153
</head>
154
 
155
<body>
156
<div class="container">
157
    <div class="row">
158
         <div class ="header">   
159
		 <h3 class="header">HOTSPOT PARTNER STORE</h3>
160
         <h4 class="header">Powered by Profit Mandi (A Unit of Spice Group)</h4>
161
         </div>
162
 
163
        <div class="header">
164
            <h5 class="header">APPLICATION FOR REGISTRATION</h5>
165
       </div>  
166
        <hr />
167
 
168
        <div class="row">
169
            <div class="col-sm-8">
170
 
171
                <form role="form" name="myform" id ="form"  enctype="multipart/form-data"  data-toggle="validator" novalidate>
172
             <h4 class="page-header">1. Registered Business Name of HSPS (in Block Letters)</h4>
21997 rajender 173
 
174
             <input type="hidden" name="_id" />
175
 
21920 rajender 176
                     <div class="form-group ">
177
 
178
                     <label for=""></label>
179
                     <input type="text" name="registeredBusinessName" id="demo" class="bform" placeholder="Business Name"/>
180
 
181
 
182
                     </div>
183
 
184
 
185
             <h4 class="page-header">2. Registered Address (In Block Letters)</h4>
186
 
187
                    <div class="form-group float-label-control">
188
                        <label for="">Line 1</label>
189
                        <input type="text" name ="line1" class="form-control" placeholder="Line 1">
190
                    </div>
191
 
192
                     <div class="form-group float-label-control">
193
                      <label for="">Line 2</label>
194
                        <input type="text" name ="line2" class="form-control" placeholder="Line 2">
195
                    </div>
196
                     <div class="form-group float-label-control">
197
                        <label for="">Line 3</label>
198
                        <input type="text" name="line3" class="form-control" placeholder="Line 3">
199
                    </div>
200
                     <div class="form-group float-label-control">
201
                        <label for="">City</label>
202
                        <input type="text" name="city" class="form-control" placeholder="City">
203
                    </div>
204
                      <div class="form-group float-label-control">
205
                        <label for="">District</label>
206
                        <input type="text" name="district" class="form-control" placeholder="District">
207
                    </div>
208
                     <div class="form-group float-label-control">
209
                        <label for="">Pincode</label>
210
                        <input  type="text" name="pincode" maxlength="6" class="form-control" pattern="[0-9]{6}" title="Please enter correct Pin Code"placeholder="Pincode">
211
                      </div>  
212
 
213
                     <div class="form-group float-label-control">
214
 
215
                      <select class="form-control" name = "state" placeholder="State">
216
                       <option value=" ">State</option>
217
                     <option value="Andaman and Nicobar Islands">Andaman and Nicobar Islands</option>
218
                            <option value="Andhra Pradesh">Andhra Pradesh</option>
219
                            <option value="Arunachal Pradesh">Arunachal Pradesh</option>
220
                            <option value="Assam">Assam</option>
221
                            <option value="Bihar">Bihar</option>
222
                            <option value="Chandigarh">Chandigarh</option>
223
                            <option value="Chhattisgarh">Chhattisgarh</option>
224
                            <option value="Dadra and Nagar Haveli">Dadra and Nagar Haveli</option>
225
                            <option value="Daman and Diu">Daman and Diu</option>
226
                            <option value="Delhi">Delhi</option>
227
                            <option value="Goa">Goa</option>
228
                            <option value="Gujarat">Gujarat</option>
229
                            <option value="Haryana">Haryana</option>
230
                            <option value="Himachal Pradesh">Himachal Pradesh</option>
231
                            <option value="Jammu and Kashmir">Jammu and Kashmir</option>
232
                            <option value="Jharkhand">Jharkhand</option>
233
                            <option value="Karnataka">Karnataka</option>
234
                            <option value="Kerala">Kerala</option>
235
                            <option value="Lakshadweep">Lakshadweep</option>
236
                            <option value="Madhya Pradesh">Madhya Pradesh</option>
237
                            <option value="Maharashtra">Maharashtra</option>
238
                            <option value="Manipur">Manipur</option>
239
                            <option value="Meghalaya">Meghalaya</option>
240
                            <option value="Mizoram">Mizoram</option>
241
                            <option value="Nagaland">Nagaland</option>
242
                            <option value="Orissa">Orissa</option>
243
                            <option value="Pondicherry">Pondicherry</option>
244
                            <option value="Punjab">Punjab</option>
245
                            <option value="Rajasthan">Rajasthan</option>
246
                            <option value="Sikkim">Sikkim</option>
247
                            <option value="Tamil Nadu">Tamil Nadu</option>
248
                            <option value="Tripura">Tripura</option>
249
                            <option value="Telangana">Telangana</option>
250
                            <option value="Uttaranchal">Uttaranchal</option>
251
                            <option value="Uttar Pradesh">Uttar Pradesh</option>
252
                            <option value="West Bengal">West Bengal</option>
253
                                              </select>
254
                    </div>
255
 
256
 
257
                      <div class="form-group float-label-control">
258
                        <label for="">Email1</label>
259
                        <input type="email" class="form-control" name="registeredEmail1" placeholder="Email1">
260
                      </div>  
261
                         <p>Example:- xyz<strong>.hsps@gmail.com</strong></p>
262
 
263
 
264
 
265
                        <div class="form-group float-label-control">
266
                        <label for="">Email2</label>
267
                        <input type="email" class="form-control" name="registeredEmail2" placeholder="Email2">
268
                      </div> 
269
 
270
 
271
                       <div class="form-group float-label-control">
272
                        <label for="">Mobile</label>
273
                        <input  type="text" class="form-control" name="mobile" maxlength = "10" pattern="[0-9]{10}" title="Please enter valid Phone number" placeholder="Mobile">
274
                      </div>  
275
 
276
                    <label>Landline</label>
277
                      <div class="form-group Pmpform">
278
                      <input type="text" name="stdcode" maxlength = "5" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="STDcode"/> 
279
 
280
 
281
                      <input type="text" name="telephone" maxlength = "10" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="Telephone"/>
282
                      </div>
283
 
284
 
285
 
286
             <h4 class="page-header">3. Type of Business Entity</h4>
287
                   <div class="funkyradio">
288
 
289
                    <div class="funkyradio-primary">
290
                        <input type="radio" name="bEntity" id="radio1" value="SaleProprietorship" required>
291
                        <label for="radio1">Proprietor</label>
292
                    </div>
293
                    <div class="funkyradio-primary">
294
                        <input type="radio" name="bEntity" id="radio2" value="Partnership" required>
295
                        <label for="radio2">Partnership</label>
296
                    </div>
297
                    <div class="funkyradio-primary">
298
                        <input type="radio" name="bEntity" id="radio3" value="PrivateLimitedCompany" required>
299
                        <label for="radio3">Private Limited company</label>
300
                    </div>
301
                    <div class="funkyradio-primary">
302
                        <input type="radio" name="bEntity" id="radio4" value="LimitedLiabilityPartnership" required>
303
                        <label for="radio4">Limited Liability Partnership</label>
304
                    </div>
305
                </div>
306
                  <div class ="Entity">
307
                    <div class="SaleProprietorship box" id ="saleSaleProprietorship">Upload <strong>Proprietership proof</strong></div>
308
                     <div class="partnership box" id="salePartnership">Upload <strong>Partnership Deed</strong></div>
309
                     </div>
310
                      <div class="limitedcompany box" id="salePrivateLimitedCompany">
311
                      <div class="form-group float-label-control">
312
                        <label for="">DIN Number</label>
313
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number">
314
                    </div>Upload <strong>Incorporation certificate,Memorandum & Article of association</strong>
315
                      </div>
316
 
317
 
318
                      <div class="LimitedLiabilityPartnership box" id="saleLimitedLiabilityPartnership">
319
 
320
 
321
                           <div class="form-group float-label-control">
322
                        <label for="">DIN Number</label>
323
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number">
324
                    </div>Upload <strong>Registration certificate & partnership Deed</strong>
325
                     </div>
326
 
327
                    <div class = "form-group file upload"> 
21997 rajender 328
                 <input type="file" accept="application/pdf,image/*" id="doc" name ="doc_bEntityDoc">
329
 
22001 rajender 330
                   <input type="hidden" name="bEntityDoc"/>
21920 rajender 331
                  <a href="somelink" id="link-bEntityDoc" style="display:none">View bEntity Document</a>
332
 
333
                    </div>
334
 
335
 
336
                     <h4 class="page-header">4. Goods And Services Tax Number(GST)</h4>
337
                    <div class="Pmpform">
338
 
339
                        <input type="text" name="gst" class="bform" placeholder="Goods And Services Tax Number"/>
340
                    </div>
341
                     <p>Provide Copy of GST document</p>
342
                    <div class = "file upload"> 
21997 rajender 343
                   <input type="file"  accept="application/pdf,image/*" name ="doc_gstDoc">
344
                     <input type="hidden" name="gstDoc"/>
21920 rajender 345
                     <a href="somelink" id="link-gstDoc" style="display:none">View GST Document</a>
346
                    </div>
347
 
348
 
349
                     <h4 class="page-header">5. Permanent Account Number(PAN)</h4>
350
                    <div class="form-group ">
351
 
352
                     <label for=""></label>
353
                     <input type="text" name="pan" maxlength="10" class="bform" placeholder="Permanent Account Number"/></div>
354
                     <p>Provide Copy of PAN </p>
355
 
356
                    <div class = "form-group file upload"> 
357
 
21997 rajender 358
                    <input type="file" accept="application/pdf,image/*" name="doc_panDoc">
359
                     <input type="hidden" name="panDoc"/>
21920 rajender 360
                   <a href="somelink" id="link-panDoc" style="display:none">View Pan Document</a>
361
                    </div>
362
 
363
 
364
             <h4 class="page-header">6. Full Details Of Business Entity</h4>
365
 
366
                   <div class="funkyradio">
367
                    <div class="funkyradio-primary">
368
                        <input type="radio" name="bPmpDetail" id="business1" value="Proprietor" required>
369
                        <label for="business1">Proprietor</label>
370
                    </div>
371
                    <div class="funkyradio-primary">
372
                        <input type="radio" name="bPmpDetail" id="business2" value="Partners" required>
373
                        <label for="business2">Partners</label>
374
                    </div>
375
                    <div class="funkyradio-primary">
376
                        <input type="radio" name="bPmpDetail" id="business3" value="Directors" required>
377
                        <label for="business3">Directors</label>
378
                    </div>
379
                </div>
380
 
381
                <div class="tablecontainer">
382
   <table class="businessdetail">
383
              <tr> 
384
              <th class ="PMPName">Name</th>
385
              <th  class="PMPAddress">Address</th> 
386
              <th class="PMPtelno">Mobile</th>
387
              <th class="PMPpan">PAN</th>
388
              <th class="PMPAdhaar">Aadhaar Number</th>
389
              <th class="PMPemail">Email</th>
390
              <th class="PMPownership">Share %</th>
391
 
392
               </tr>
393
            <tr>
394
 
395
                   <td class="form-group"><input type="text" name="proprietorBusineesName"size="25"></td>
396
                   <td class="form-group"><textarea row="3" name="proprietorAddress"></textarea></td>
397
                   <td class="form-group"><input type="text" name="proprietorPhone" maxlength="10" pattern="[0-9]{10}"size="10"></th>
398
                   <td class="form-group"><input type="text" name="proprietorPan" maxlength="10" title="Please enter correct pan number"size="10"></td>
399
                    <td class="form-group"><input type="text"  name= "proprietorAdhaar" size="15"></td>
400
                   <td class="form-group"><input type="email"  name= "proprietorEmail" size="20"></td>
401
                   <td class="form-group"><input type="text" pattern="[0-9]" name="proprietorOwner" size="10"></td>
402
 
403
                   </tr>
404
 
405
 
406
            </table>
407
 
408
            </div>
409
            <div class="Partners pmp" id= "PmpPartners">
410
            <table class="businessdetail">
411
 
412
             <tr> 
413
              <th class ="PMPName">Name</th>
414
              <th  class="PMPAddress">Address</th> 
415
              <th class="PMPtelno">Mobile</th>
416
              <th class="PMPpan">PAN</th>
417
              <th class="PMPAdhaar">Aadhaar Number</th>
418
              <th class="PMPemail">Email</th>
419
              <th class="PMPownership">Share %</th>
420
 
421
               </tr>
422
                <tr>
423
 
424
                   <td class="form-group"><input name="partnerName1"type="text" size="25"></td>
425
                   <td class="form-group"><textarea name="partnerAddress1" type="text" size="60"></textarea></td>
426
                   <td class="form-group"><input name = "partnerPhone1" pattern="[0-9]{10}"type="text" size="10"></th>
427
                   <td class="form-group"><input  name ="partnerPan1"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
428
                    <td class="form-group"><input name="partnerAdhaar1" type="text"  size="15"></td>
429
                   <td class="form-group"><input name="partnerEmail1" type="email"  size="20"></td>
430
                   <td class="form-group"><input name="partnerOwner1" type="text"pattern="[0-9]"size="10"></td>
431
 
432
                   </tr>
433
 
434
 
435
            </table>
436
 
437
                   <table class="businessdetail">
438
 
439
             <tr> 
440
              <th class ="PMPName">Name</th>
441
              <th  class="PMPAddress">Address</th> 
442
              <th class="PMPtelno">Mobile</th>
443
              <th class="PMPpan">PAN</th>
444
              <th class="PMPAdhaar">Aadhaar Number</th>
445
              <th class="PMPemail">Email</th>
446
              <th class="PMPownership">Share %</th>
447
 
448
               </tr>
449
              <tr>
450
 
451
                   <td class="form-group"><input name="partnerName2"type="text" size="25"></td>
452
                   <td class="form-group"><textarea name="partnerAddress2" type="text" size="60"></textarea></td>
453
                   <td class="form-group"><input name = "partnerPhone2" pattern="[0-9]{10}" type="text" size="10"></th>
454
                   <td class="businesspan"><input  name ="partnerPan2"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
455
                   <td class="form-group"><input name="partnerAdhaar2" type="text" size="15"></td>
456
                   <td class="form-group"><input name="partnerEmail2" type="email" size="20"></td>
457
                   <td class="form-group"><input name="partnerOwner2" pattern="[0-9]" type="text" size="10"></td>
458
 
459
                   </tr>
460
 
461
            </table>
462
                   <table class="businessdetail">
463
             <tr> 
464
            <th class ="PMPName">Name</th>
465
              <th  class="PMPAddress">Address</th> 
466
              <th class="PMPtelno">Mobile</th>
467
              <th class="PMPpan">PAN</th>
468
              <th class="PMPAdhaar">Aadhaar Number</th>
469
              <th class="PMPemail">Email</th>
470
              <th class="PMPownership">Share %</th>
471
 
472
               </tr>
473
                 <tr>
474
 
475
                   <td class="form-group"><input name="partnerName3"type="text" size="25"></td>
476
                   <td class="form-group"><textarea name="partnerAddress3" type="text" size="60"></textarea></td>
477
                   <td class="form-group"><input name = "partnerPhone3" type="text"  maxlength = "10" pattern="[0-9]{10}"  size="10"></th>
478
                   <td class="form-group"><input  name ="partnerPan3"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
479
                    <td class="form-groupr"><input name="partnerAdhaar3" type="text" size="15"></td>
480
                   <td class="form-group"><input name="partnerEmail3"  type="email" size="20"></td>
481
                   <td class="form-group"><input name="partnerOwner3" pattern="[0-9"  type="text" size="10"></td>
482
 
483
                   </tr>
484
 
485
 
486
            </table>
487
 
488
 
489
 
490
           <table class="businessdetail">
491
       <tr> 
492
                <th class ="PMPName">Name</th>
493
              <th  class="PMPAddress">Address</th> 
494
              <th class="PMPtelno">Mobile</th>
495
              <th class="PMPpan">PAN</th>
496
              <th class="PMPAdhaar">Aadhaar Number</th>
497
              <th class="PMPemail">Email</th>
498
              <th class="PMPownership">Share %</th>
499
               </tr>
500
               <tr>
501
 
502
                   <td class="form-group"><input name="partnerName4"type="text" size="25"></td>
503
                   <td class="form-group"><textarea name="partnerAddress4" type="text" size="60"></textarea></td>
504
                   <td class="form-group"><input name = "partnerPhone4"  pattern="[0-9]{10}" type="text" size="10"></th>
505
                   <td class="form-group"><input  name ="partnerPan4"type="text" maxlength = "10"title="Please enter correct pan number"size="10"></td>
506
                    <td class="form-group"><input name="partnerAdhaar4" type="text" size="15"></td>
507
                   <td class="form-group"><input name="partnerEmail4" type="email" size="20"></td>
508
                   <td class="form-group"><input name="partnerOwner4" pattern="[0-9]" type="text" size="10"></td>
509
 
510
                   </tr>
511
 
512
 
513
            </table>
514
 
515
            </div>
516
 
517
 
518
             <div class="Directors pmp" id= "PmpDirectors">
519
            <table class="businessdetail">
520
               <tr> 
521
               <th class ="PMPName">Name</th>
522
              <th  class="PMPAddress">Address</th> 
523
              <th class="PMPtelno">Mobile</th>
524
              <th class="PMPpan">PAN</th>
525
              <th class="PMPAdhaar">Aadhaar Number</th>
526
              <th class="PMPemail">Email</th>
527
              <th class="PMPownership">Share %</th>
528
 
529
               </tr>
530
               <tr>
531
                   <td class="form-group"><input name="shareholderName1"type="text" size="25"></td>
532
                   <td class="form-group"><textarea name="shareholderAddress1" type="text" size="60"></textarea></td>
533
                   <td class="form-group"><input name = "shareholderPhone1" pattern="[0-9]{10}" type="text" size="10"></th>
534
                   <td class="form-group"><input  name ="shareholderPan1"type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
535
                   <td class="form-group"><input name="shareholderAdhaar1" type="text" size="15"></td>
536
                   <td class="form-group"><input name="shareholderEmail1" type="email" size="20"></td>
537
                   <td class="form-group"><input name="shareholderOwner1" pattern="[0-9]" type="text" size="10"></td>
538
 
539
                   </tr>
540
 
541
 
542
            </table>
543
 
544
                   <table class="businessdetail">
545
          <tr> 
546
                <th class ="PMPName">Name</th>
547
              <th  class="PMPAddress">Address</th> 
548
              <th class="PMPtelno">Mobile</th>
549
              <th class="PMPpan">PAN</th>
550
              <th class="PMPAdhaar">Aadhaar Number</th>
551
              <th class="PMPemail">Email</th>
552
              <th class="PMPownership">Share %</th>
553
               </tr>
554
                 <tr>
555
                   <td class="form-group"><input name="shareholderName2"type="text" size="25"></td>
556
                   <td class="form-group"><textarea name="shareholderAddress2" type="text" size="60"></textarea></td>
557
                   <td class="form-group"><input name = "shareholderPhone2" pattern="[0-9]{10}" type="text" size="10"></th>
558
                   <td class="form-group"><input  name ="shareholderPan2"type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
559
                    <td class="form-group"><input name="shareholderAdhaar2" type="text" size="15"></td>
560
                   <td class="form-group"><input name="shareholderEmail2"  type="email" size="20"></td>
561
                   <td class="form-group"><input name="shareholderOwner2" pattern="[0-9]"  type="text" size="10"></td>
562
 
563
                   </tr>
564
            </table>
565
 
566
                   <table class="businessdetail">
567
              <tr> 
568
                <th class ="PMPName">Name</th>
569
              <th  class="PMPAddress">Address</th> 
570
              <th class="PMPtelno">Mobile</th>
571
              <th class="PMPpan">PAN</th>
572
              <th class="PMPAdhaar">Aadhaar Number</th>
573
              <th class="PMPemail">Email</th>
574
              <th class="PMPownership">Share %</th>
575
 
576
               </tr>
577
                   <tr>
578
                   <td class="form-group"><input name="shareholderName3"type="text" size="25"></td>
579
                   <td class="form-group"><textarea name="shareholderAddress3" type="text" size="60"></textarea></td>
580
                   <td class="form-group"><input name = "shareholderPhone3" pattern="[0-9]{10}" type="text" size="10"></th>
581
                   <td class="form-group"><input  name ="shareholderPan3" type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
582
                   <td class="form-group"><input name="shareholderAdhaar3" type="text" size="15"></td>
583
                   <td class="form-group"><input name="shareholderEmail3" type="email" size="20"></td>
584
                   <td class="form-group"><input name="shareholderOwner3" pattern="[0-9]" type="text" size="10"></td>
585
 
586
                   </tr>
587
 
588
            </table>
589
 
590
                   <table class="businessdetail">
591
             <tr> 
592
                <th class ="PMPName">Name</th>
593
              <th  class="PMPAddress">Address</th> 
594
              <th class="PMPtelno">Mobile</th>
595
              <th class="PMPpan">PAN</th>
596
              <th class="PMPAdhaar">Aadhaar Number</th>
597
              <th class="PMPemail">Email</th>
598
              <th class="PMPownership">Share %</th>
599
               </tr>
600
                     <tr>
601
                   <td class="form-group"><input name="shareholderName4" type="text" size="25"></td>
602
                   <td class="form-group"><textarea name="shareholderAddress4" type="text" size="60"></textarea></td>
603
                   <td class="form-group"><input name = "shareholderPhone4" type="text" pattern="[0-9]{10}" size="10"></th>
604
                   <td class="form-group"><input  name ="shareholderPan4" type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
605
                    <td class="form-group"><input name="shareholderAdhaar4" type="text" size="15"></td>
606
                   <td class="form-group"><input name="shareholderEmail4"  type="email" size="20"></td>
607
                   <td class="form-group"><input name="shareholderOwner4" pattern="[0-9]"  type="text" size="10"></td>
608
 
609
                   </tr>
610
 
611
 
612
            </table>
613
 
614
            </div>
615
 
616
         <h4 class="page-header">7. Store Manager Details</h4>
617
 
618
 
619
                    <div class="form-group">
620
                    <label for="">Name
621
                    <input type="text" name="managerName"placeholder="Name"></label>
622
                    <label for="">Mobile
623
                        <input type="text" name="managerNo" pattern="[0-9]{10}" title="Please enter Valid Mobile number" placeholder="Mobile No"> </label>  
624
                    <label for="">Email
625
                        <input type="email" name="managerEmail"size="25px" placeholder="Emailid"> </label>  
626
 
627
                    </div>
628
 
629
 
630
            <h4 class="page-header">8. Manpower Details</h4>
631
 
632
               <div class="form-group">
633
                    <label for="">Number of Employees
634
                    <input type="text" pattern="[0-9]" name="noOfEmployees"placeholder="Number of Employees"></label>
635
                    <label for="">Number of Management Staff
636
                        <input type="text" pattern="[0-9]" name="managementStaff" placeholder="Management Staff"> </label>  
637
 
638
                    </div>
639
 
640
              <h4 class="page-header">9. Experience In Telecom Trade/other Trade (Brand & Product Category)</h4>
641
                <div class="bcontacts">
642
                   <textarea rows="4" name="experienceinTelecome"cols="50" placeholder="Describe yourself here..."></textarea> 
643
                </div>
644
 
645
            <h4 class="page-header">10. Description of Existing Business & Annual Turnover</h4>
646
                <div class="bcontacts">
647
                      <textarea rows="4" name="descriptionofExistingBusiness"cols="50" placeholder="Describe yourself here..."></textarea>
648
                </div>
649
                <p>Please Provide ITR of last Two years</p>
650
                <div class = "form-group file upload"> 
21997 rajender 651
                  <input type="file" accept="application/pdf,image/*" name ="doc_itrDoc">
652
                      <input type="hidden" name="itrDoc"/>
21920 rajender 653
                <a href="somelink" id="link-itrDoc" style="display:none">View ITR Document</a>
654
                    </div>
655
 
656
 
657
            <h4 class="page-header">11.Business Model</h4>
658
 
659
            <div class="btn-group">
660
                    <label class="btn btn-default">
661
                   <input type="radio" name="businessModel" value="Retailer" required>
662
                   <span>Retailer</span>
663
                  </label>
664
                <label class="btn btn-default">
665
                    <input type="radio" name="businessModel" value="Distributor" required>
666
                    <span>Distributor</span>
667
                </label>
668
                <label class="btn btn-default">
669
                    <input type="radio" name="businessModel" value="Franchises" required>
670
                    <span>Franchise</span>
671
                </label>
672
                  <label class="btn btn-default">
673
                    <input type="radio" name="businessModel" value="Other" required>
674
                    <span>Other</span>
675
                </label>
676
              </div>
677
 
678
 
679
          <h4 class="page-header">12. Selling Online (if yes, please specify Portal Names)</h4>
680
 
681
                    <div class="btn-group">
682
                    <label class="btn btn-default">
683
                   <input type="radio" name="sellingOnline" value="yes">
684
                   <span>Yes</span>
685
                  </label>
686
                <label class="btn btn-default">
687
                    <input type="radio" name="sellingOnline" value="no">
688
                    <span>No</span>
689
                </label>
690
              </div>
691
                   <div class="form-group portal Names" id = "sellingyes">
692
                   <label>Portal Names</label>
693
                       <input type="text" name="portalName1" size="25">
694
                       <input type="text" name="portalName2" size="25">
695
                       <input type="text" name="portalName3" size="25">
696
                  </div>
697
            <h4 class="page-header">13. Area of Shop(in Sq Feet)</h4>
698
              <div>
699
                 <div class="form-group">
700
                    <label>
701
 
702
                    <input type="number" name="east"  placeholder="East(Sq Feet)">
703
                    <input type="number" name="west"  placeholder="West(Sq Feet)">
704
                    <input type="number" name="north" placeholder="North(Sq Feet)"> 
705
                    </label>
706
                </div>
707
                    <br>
708
                      <div class="form-group">
709
                    <label>
710
 
711
                    <input type="number" name="south" placeholder="South(Sq Feet)">
712
                    <input type="number" name="front" placeholder="Front(Sq Feet)">
713
                    <input type="number" name="roadSize" placeholder="Road Size in Front(Sq Feet)">
714
 
715
                    </label>
716
                </div>
717
 
718
                  </div>  
719
                  <div class="shopArea">
720
                   <div class="btn-group">
721
                    <label class="btn btn-default">
722
                   <input type="radio" name="shopArea" value="Singleside">
723
                   <span>Single Side</span>
724
                  </label>
725
                <label class="btn btn-default">
726
                    <input type="radio" name="shopArea" value"Twoside">
727
                    <span>Two Side</span>
728
                </label>
729
                  <label class="btn btn-default">
730
                    <input type="radio" name="shopArea" value="Corner">
731
                    <span>Corner</span>
732
                </label>
733
              </div>
734
              </div>
735
 
736
 
737
              <h4 class="page-header">14. Status of Shop</h4>
738
 
739
                 <div class="btn-group">
740
                    <label class="btn btn-default">
741
                   <input type="radio" name="shopStatus" value="semifurnished">
742
                   <span>Semi Furnished</span>
743
                  </label>
744
                <label class="btn btn-default">
745
                    <input type="radio" name="shopStatus" value="fullfurnished">
746
                    <span>Fully Furnished</span>
747
                </label>
748
                </div>
749
 
750
                 <div class="checkboxes status" id ="shopsemifurnished">
751
                 <div class="btn btn-default">
752
   <label for="success1" class="btn btn-success">Flooring<input type="checkbox" name="flooring" 
753
          value ="flooring" id="success1" class="badgebox"><span class="badge">&check;</span></label>
754
        <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>
755
 
756
 
757
              </div>
758
            </div>
759
 
760
<div class ="checkboxes status"  id ="shopfullfurnished">
761
          <div class="row text-center">
762
    <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>
763
        <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>
764
        <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>
765
        <label for="success" class="btn btn-success">Electricity<input type="checkbox" name="electricity" 
766
          value ="yes" id="success" class="badgebox"><span class="badge">&check;</span></label>
767
        <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>
768
  </div>
769
    </div>
770
 
771
 
772
              <h4 class="page-header">15. Shop Available At</h4>
773
 
774
                     <div class="btn-group">
775
                    <label class="btn btn-default">
776
                   <input type="radio" name="shopAvailbility" value="Basement">
777
                   <span>Basement</span>
778
                  </label>
779
                <label class="btn btn-default">
780
                    <input type="radio" name="shopAvailbility" value="Groundfloor">
781
                    <span>Ground Floor</span>
782
                </label>
783
                  <label class="btn btn-default">
784
                    <input type="radio" name="shopAvailbility" value="firstfloor">
785
                    <span>First Floor</span>
786
                </label>
787
 
788
                  <label class="btn btn-default">
789
                    <input type="radio" name="shopAvailbility" value="secondfloor">
790
                    <span>Second Floor</span>
791
                </label>
792
 
793
                 <label class="btn btn-default">
794
                    <input type="radio" name="shopAvailbility" value="thirdfloor">
795
                    <span>Third Floor</span>
796
                </label>
797
                </div>
798
 
799
                <div class="form-group bdetail">
800
                   <p>Provide pictures of the shop from 3 different angles, ceiling and flooring</p>
21997 rajender 801
	                <input type="file" name="doc_angleDoc1" accept="application/pdf,image/*" >
802
	                  <input type="hidden" name="angleDoc1"/> 
803
	                  <a href="somelink" id="link-angleDoc1" style="display:none">View angleDoc1 Document</a>
804
	                  <input type="file" name="doc_angleDoc2" accept="application/pdf,image/*" >
805
	                  <input type="hidden" name="angleDoc2"/>
806
                      <a href="somelink" id="link-angleDoc2" style="display:none">View angleDoc2 Document</a>   
807
                    <input type="file" name="doc_angleDoc3"  accept="application/pdf,image/*" >
808
                      <input type="hidden" name="angleDoc3"/>
21920 rajender 809
                      <a href="somelink" id="link-angleDoc3" style="display:none">View angleDoc3 Document</a>    
21997 rajender 810
                    <input type="file" name="doc_angleDoc4"  accept="application/pdf,image/*" >
811
                      <input type="hidden" name="angleDoc4"/>   
21920 rajender 812
                      <a href="somelink" id="link-angleDoc4" style="display:none">View angleDoc4 Document</a>    
21997 rajender 813
                    <input type="file" name="doc_angleDoc5" accept="application/pdf,image/*">
814
                      <input type="hidden" name="angleDoc5"/>
21920 rajender 815
                <a href="somelink" id="link-angleDoc5" style="display:none">View angleDoc5Document</a>         
816
                  </div>
817
 
818
         <h4 class="page-header">16. Location of Shop</h4>
819
                        <div class="btn-group">
820
                    <label class="btn btn-default">
821
                   <input type="radio" name="location" value="shoppingMall">
822
                   <span>Shopping Mall</span>
823
                  </label>
824
                <label class="btn btn-default">
825
                    <input type="radio" name="location" value="MainMobileMarket">
826
                    <span>Main Mobile Market</span>
827
                </label>
828
                  <label class="btn btn-default">
829
                    <input type="radio" name="location" value="LocalMarket">
830
                    <span>Local Market</span>
831
                </label>
832
 
833
                </div>
834
 
835
 
836
 
837
             <h4 class="page-header">17.Nearest Mobile Store</h4>
838
                           <div class="btn-group">
839
                    <label class="btn btn-default">
840
                   <input type="radio" name="nearestStore" value="100mtrs">
841
                   <span>100Mtrs</span>
842
                  </label>
843
                <label class="btn btn-default">
844
                    <input type="radio" name="nearestStore" value="200mtrs">
845
                    <span>200Mtrs</span>
846
                </label>
847
                  <label class="btn btn-default">
848
                    <input type="radio" name="nearestStore" value="500mtrs">
849
                    <span>500Mtrs</span>
850
                </label>
851
 
852
                </div>
853
 
854
                 <div class="form-group location">
855
                   <label>Name of the Shop</label>
856
                       <input type="text" size ="35" name="storeName">
857
                       <br>
858
                       <br>
859
                        <label>Address of the Shop</label>
860
                       <input type="text" size ="65" name="storeAddress">
861
                  </div>
862
 
863
 
864
 
865
            <h4 class="page-header">18. Ownership of Shop</h4>
866
 
867
                    <div class="btn-group">
868
                    <label class="btn btn-default">
869
                   <input type="radio" name="ownership" value="Selfowned">
870
                   <span>Self Owned</span>
871
                  </label>
872
                <label class="btn btn-default">
873
                    <input type="radio" name="ownership" value="Rented">
874
                    <span>Rented</span>
875
                </label>
876
                  <label class="btn btn-default">
877
                    <input type="radio" name="ownership" value="lease">
878
                    <span>Lease</span>
879
                </label>
880
                  </label>
881
                  <label class="btn btn-default">
882
                    <input type="radio" name="ownership" value="collaboration">
883
                    <span>Collaboration</span>
884
                </label>
885
 
886
                </div>
887
 
888
                 <div class="form-group bdetail">
889
                   <p>Provide relevant documents (Electricity bill/Rent Agreement/Lease Deed)to prove the status of ownership</p>
21997 rajender 890
                       <input type="file" accept="application/pdf,image/*" name="doc_ownershipDoc">
891
                     <input type="hidden" name="ownershipDoc"/>
21921 rajender 892
                         <a href="somelink" id="link-ownershipDoc" style="display:none">View OwnershipDoc Document</a>   
21920 rajender 893
                   </div>
894
 
895
 
896
           <h4 class="page-header">19. Insurance of Shop (if yes, please provide the copy of the same)</h4>
897
 
898
 
899
                    <div class="btn-group">
900
                    <label class="btn btn-default">
901
                   <input type="radio" name="insurance" value="yes">
902
                   <span>Yes</span>
903
                  </label>
904
                <label class="btn btn-default">
905
                    <input type="radio" name="insurance" value="no">
906
                    <span>No</span>
907
                </label>
908
              </div>
909
 
910
                 <div class="form-group insurance doc"  id= "docyes">
911
                  <p>Please provide copy of insurance document</p>
21997 rajender 912
                  <input type="file" accept="application/pdf,image/*" name="doc_insuranceDoc">
913
                    <input type="hidden" name="insuranceDoc"/>
914
                 <a href="somelink" id="link-insuranceDoc" style="display:none">View InsuranceDoc Document</a>    
21920 rajender 915
                   </div>
916
 
917
 
918
         <h4 class="page-header">20. Loan on Shop (LAP/BL/CC/others)</h4>
919
 
920
                     <div class="btn-group">
921
                    <label class="btn btn-default">
922
                   <input type="radio" name="loan" value="yes">
923
                   <span>Yes</span>
924
                  </label>
925
                <label class="btn btn-default">
926
                    <input type="radio" name="loan" value="no">
927
                    <span>No</span>
928
                </label>
929
              </div>
930
 
931
                 <div class="form-group loan document" id ="documentyes">
932
                  <p>Please provide current statement Letter</p>
21997 rajender 933
                    <input type="file" accept="application/pdf,image/*" name="doc_loanDoc">
934
                     <input type="hidden" name="loanDoc"/>
21920 rajender 935
                     <a href="somelink" id="link-loanDoc" style="display:none">View loanDoc Document</a>  
936
 
937
                      <p>Please provide current sanction Letter</p>
21997 rajender 938
                     <input type="file" accept="application/pdf,image/*" name="doc_sanctionDoc">
939
                     <input type="hidden" name="sanctionDoc"/>
21920 rajender 940
                        <a href="somelink" id="link-sanctionDoc" style="display:none">View sanctionDoc Document</a>  
941
 
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>
949
                        <input type="text" name="accountNumber"class="form-control" placeholder="Account Number">
950
                    </div>
951
                     <div class="form-group float-label-control">
952
                        <label for="">Bank Name</label>
953
                        <input type="text" name="bankName"class="form-control" placeholder="Bank Name">
954
                    </div>
955
                     <div class="form-group float-label-control">
956
                        <label for="">IFSC Code</label>
957
                        <input type="text" name="ifscCode"class="form-control" placeholder="IFSC Code">
958
                    </div>
959
                     <div class="form-group float-label-control">
960
                        <label for="">Branch Name</label>
961
                        <input type="text" name="branchName" class="form-control" placeholder="Branch Name">
962
                    </div>
963
                     <div >
964
                  <p>Please attach the copy of cancelled cheque</p>
965
                      <div class="form-group">
21997 rajender 966
                  <input type="file" name="doc_chequeCopy" accept="application/pdf,image/*">
967
                     <input type="hidden" name="chequeCopy"/>
21920 rajender 968
              <a href="somelink" id="link-chequeCopy" style="display:none">View chequeCopy Document</a>  
969
 
970
                   </div>
971
 
972
 
973
                  <h4 class="page-header">22. HSPS Bank Account Detail</h4> 
974
 
975
                  <p>Please deposit amount of <strong> Rs 1 Lac </strong>as advance payment in following account through NEFT and submit the UTR No.</p>
976
                    <div class="form-group float-label-control">
977
                        <label for="">UTR Number</label>
978
                        <input type="text" name="utr" class="form-control" placeholder="UTR No">
979
                    </div>
980
                    <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>
981
 
982
 
983
 
984
                      <div class ="Account">
985
                      <label>Account Name: New Spice Solutions Pvt Ltd</label><br>
986
                       <label>Bank Name: IndusInd Bank Ltd.</label><br>
987
                        <label>Account No.:201000488351</label><br>
988
                        <label>Branch:M-56, Greater Kailash-II, Main Market New Delhi-110048</label><br>
989
                         <label>IFSC:INDB0000012</label><br>
990
                        </div>
991
 
992
                <div class="submit">
993
                    <button type="submit" class="btn btn-success btn-lg">Submit</button>
994
                </div>
995
 
996
                <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>
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998
 
999
 
1000
 
1001
 <!--             <fieldset hidden disabled="disabled">
1002
              <h4 class="page-header">PMP STORE REGISTRATION APPROVAL</h4>
1003
                 <p>(FOR OFFICE USE ONLY)</P>
1004
 
1005
                <div class=breg>
1006
                 <div class=bApproval>
1007
 
1008
                  <label>Recommended by</label>
1009
                  <input type="text" name = "recommended"class="reg-control" size="50">
1010
 
1011
                  </div>
1012
                  <br>
1013
 
1014
                    <div class=bApproval>
1015
                  <label>Business Manager</label>
1016
                  <input type="text" name=" bManager" class="reg-control" size="50">
1017
                </div>
1018
                      <br>
1019
                        <div class=bApproval>
1020
                    <label>Operations Manager</label>
1021
                  <input type="text"name="operation"class="reg-control"  size="50">
1022
                </div>
1023
                  <br>
1024
               <div class=bApproval>
1025
                     <label>BusinessHeadCategoryHead</label>
1026
                  <input type="text" name="bhead"class="reg-control" size="50">
1027
                </div>
1028
 
1029
 
1030
                 </div>
1031
               </fieldset> -->
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1033
                      </form>
1034
                    </div>
1035
          </div>
1036
   <div class="col-sm-4">
1037
                <div class="panel panel-default">
1038
 
1039
                    <div class="panel-body">
1040
 
1041
 
1042
                   <label>Spice Global Knowledge Park - 6th Floor, Plot No.19A & 19B, Sector 125, Noida, UP - 201301</label>
1043
                   <br>
1044
                    <label>Email - care@profitmandi.com</<label>
1045
                    <br> 
1046
                    <label>Contact - 8588842949 </label>
1047
                    </div>
1048
                </div>
1049
            </div>
1050
 
1051
        </div>
1052
 
1053
    </div>
1054
    </div>
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    <div id="ajax-spinner" style="display:none;">
1056
        <img src="$action.getContextPath()/images/loading.gif" class="loading-image">
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    </div>
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</body>
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</html>