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kshitij.so |
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<html>
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<head>
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<script type="text/javascript" src="js/jquery-1.10.2.min.js"></script>
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<link rel="stylesheet" href="css/bootstrap.min.css"/>
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<link rel="stylesheet" type="text/css" href="css/main.css"/>
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<link rel="stylesheet" href="css/bootstrap-theme.min.css" />
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<script src="js/bootstrap.min.js" type="script/javascript"></script>
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<script src="js/bootstrapValidator.js"></script>
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<script src="js/reg.js"></script>
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<script src="js/reqformvalidator.js"></script>
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<script type="text/javascript">
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$(document).ready(function(){
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$("input[name$='bEntity']").click(function() {
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var test1 = $(this).val();
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$(".box").hide();
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$("#sale" + test1).show();
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});
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});
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</script>
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<script type="text/javascript">
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$(document).ready(function(){
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$("input[name$='bPmpDetail']").click(function() {
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kshitij.so |
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var test1 = $(this).val();
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$(".pmp").hide();
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$("#Pmp" + test1).show();
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});
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});
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</script>
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<script type="text/javascript">
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$(document).ready(function(){
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rajender |
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$("input[name$='shopStatus']").click(function() {
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var test1 = $(this).val();
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$(".status").hide();
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$("#shop" + test1).show();
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});
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});
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</script>
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<script type="text/javascript">
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$(document).ready(function(){
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rajender |
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$("input[name$='sellingOnline']").click(function() {
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var test1 = $(this).val();
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$(".Names").hide();
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$("#selling" + test1).show();
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});
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});
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</script>
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<script type="text/javascript">
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$(document).ready(function(){
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rajender |
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$("input[name$='insurance']").click(function() {
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var test1 = $(this).val();
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$(".doc").hide();
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$("#doc" + test1).show();
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});
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});
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</script>
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<script type="text/javascript">
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$(document).ready(function(){
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$("input[name$='loan']").click(function() {
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var test1 = $(this).val();
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$(".document").hide();
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$("#document" + test1).show();
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$("#showHide").show();
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});
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});
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function queryStringToJSON(queryString) {
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var pairs = queryString.split('&');
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var result = {};
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pairs.forEach(function(pair) {
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pair = pair.split('=');
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result[pair[0]] = decodeURIComponent(pair[1] || '');
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});
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return result;
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}
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var oResult ={Branchname: "jnkmk",DinNumber: "8327592895",ExperienceinTelecome: "kdnslgrgjemgk",GSTNoDate: "29309238033902",IFSCcode: "kmk",IncomeTaxPanNo: "8384705257029",Insurance: "no",Managementstaff: "9392",MobileNo: "3288702375",North: "",ProprietorAddress: "nsdln",Proprietoremail: "jnefkji",Proprietorowner: "nsja",Proprietorpan: "nsdjak",Proprietorphone: "84u50",ProprietorusineesName: "mnsdvns",RegisteredAddress1: "wz-127 tilak nagar",RegisteredAddress2: "",RegisteredAddress3: "",RegisteredBusinessName: "spice+mobile",accountnumber: "nk",bEntity: "Partnership",bPmpdetail: "Proprietor",bankname: "kmk",businessmodel: "Retailer",city: "delhi",contactemail1: "84300293-92",contactemail2: "",contactname1: "nas+c",contactname2: "",contactno1: "8435092",contactno2: "",descriptionofExistingbusiness: "jsdnkglelr",east: "34",front: "",loan: "yes",location: "shoppingMall",neareststore: "100mtrs",noofemployess: "823u9",ownership: "Rented",partnerAddress1: "",partnerAddress2: "",partnerAddress3: "",partnerAddress4: "",partnerName1: "",partnerName2: "",partnerName3: "",partnerName4: "",partneremail1: "",partneremail2: "",partneremail3: "",partneremail4: "",partnerowner1: "",partnerowner2: "",partnerowner3: "",partnerowner4: "",partnerpan1: "",partnerpan2: "",partnerpan3: "",partnerpan4: "",partnerphone1: "",partnerphone2: "",partnerphone3: "",partnerphone4: "",pincode: "110018",portalName1: "",portalName2: "",portalName3: "",roadsize: "",sellingonline: "no",shareholderAddress1: "",shareholderAddress2: "",shareholderAddress3: "",shareholderAddress4: "",shareholderName1: "",shareholderName2: "",shareholderName3: "",shareholderName4: "",shareholderemail1: "",shareholderemail2: "",shareholderemail3: "",shareholderemail4: "",shareholderowner1: "",shareholderowner2: "",shareholderowner3: "",shareholderowner4: "",shareholderpan1: "",shareholderpan2: "",shareholderpan3: "",shareholderpan4: "",shareholderphone1: "",shareholderphone2: "",shareholderphone3: "",shareholderphone4: "",shopArea: "on",shopAvailbility: "Groundfloor",shopWashroom: "Washroom",shopWater: "Watersupply",shopstatus: "fullfurnished",south: "49",state: "Haryana",storeAddress: "",storename: "",telno: "7597209570",west: "32"}
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function jQFormSerializeArrToJson(formSerializeArr){
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var jsonObj = {};
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jQuery.map( formSerializeArr, function( n, i ) {
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jsonObj[n.name] = n.value;
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});
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return jsonObj;
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}
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</script>
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</head>
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<body>
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<div class="container">
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<div class="row">
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<div class ="header">
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<h3 class="header">HOTSPOT PARTNER STORE powered by PROFIT MANDI</h3>
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<h4 class="header">(Unit of Spice Group)</h4>
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</div>
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<div class="header">
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<h5 class="header">APPLICATION FOR REGISTRATION</h5>
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</div>
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<hr />
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<div class="row">
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<div class="col-sm-8">
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<form role="form" name="myform" id ="form" enctype="multipart/form-data" data-toggle="validator" novalidate>
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<h4 class="page-header">1. Registered Business Name of HSPS(in Block Letters)</h4>
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<div class="form-group ">
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<label for=""></label>
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rajender |
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<input type="text" name="registeredBusinessName" id="demo" class="bform" placeholder="Business Name"/>
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</div>
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<h4 class="page-header">2. Registered Address (In Block Letters)</h4>
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<div class="form-group float-label-control">
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<label for="">RegisteredAddress1</label>
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rajender |
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<input type="text" name ="registeredAddress1" class="form-control" placeholder="Address 1">
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</div>
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<div class="form-group float-label-control">
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<label for="">Address 2</label>
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rajender |
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<input type="text" name ="registeredAddress2"class="form-control" placeholder="Address 2">
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</div>
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<div class="form-group float-label-control">
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<label for="">Address 3</label>
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rajender |
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<input type="text" name="registeredAddress3" class="form-control" placeholder="Address 3">
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</div>
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<div class="form-group float-label-control">
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<label for="">City</label>
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<input type="text" name="city" class="form-control" placeholder="City">
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</div>
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<div class="form-group float-label-control">
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<label for="">Pincode</label>
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<input type="text" name="pincode" maxlength="6" class="form-control" pattern="[0-9]{6}" title="Please enter correct Pin Code"placeholder="Pincode">
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</div>
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<div class="form-group float-label-control">
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<select class="form-control" name = "state" placeholder="State">
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<option value=" ">State</option>
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<option value="Andaman and Nicobar Islands">Andaman and Nicobar Islands</option>
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<option value="Andhra Pradesh">Andhra Pradesh</option>
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<option value="Arunachal Pradesh">Arunachal Pradesh</option>
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<option value="Assam">Assam</option>
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<option value="Bihar">Bihar</option>
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<option value="Chandigarh">Chandigarh</option>
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<option value="Chhattisgarh">Chhattisgarh</option>
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<option value="Dadra and Nagar Haveli">Dadra and Nagar Haveli</option>
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<option value="Daman and Diu">Daman and Diu</option>
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<option value="Delhi">Delhi</option>
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<option value="Goa">Goa</option>
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<option value="Gujarat">Gujarat</option>
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<option value="Haryana">Haryana</option>
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<option value="Himachal Pradesh">Himachal Pradesh</option>
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<option value="Jammu and Kashmir">Jammu and Kashmir</option>
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<option value="Jharkhand">Jharkhand</option>
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<option value="Karnataka">Karnataka</option>
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<option value="Kerala">Kerala</option>
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<option value="Lakshadweep">Lakshadweep</option>
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<option value="Madhya Pradesh">Madhya Pradesh</option>
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<option value="Maharashtra">Maharashtra</option>
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<option value="Manipur">Manipur</option>
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<option value="Meghalaya">Meghalaya</option>
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<option value="Mizoram">Mizoram</option>
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<option value="Nagaland">Nagaland</option>
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<option value="Orissa">Orissa</option>
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<option value="Pondicherry">Pondicherry</option>
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<option value="Punjab">Punjab</option>
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<option value="Rajasthan">Rajasthan</option>
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<option value="Sikkim">Sikkim</option>
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<option value="Tamil Nadu">Tamil Nadu</option>
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<option value="Tripura">Tripura</option>
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<option value="Telangana">Telangana</option>
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<option value="Uttaranchal">Uttaranchal</option>
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<option value="Uttar Pradesh">Uttar Pradesh</option>
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<option value="West Bengal">West Bengal</option>
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</select>
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</div>
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<div class="form-group float-label-control">
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<label for="landline">Landline</label>
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<input type="text" class="form-control" name="Landline" maxlength = "10" pattern="[0-9]{10}" title="Please enter valid Phone number" placeholder="Landline">
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</div>
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<div class="form-group float-label-control">
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<label for="">Mobile</label>
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rajender |
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<input type="text" class="form-control" name="mobile" maxlength = "10" pattern="[0-9]{10}" title="Please enter valid Phone number" placeholder="Mobile">
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</div>
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<div class="form-group float-label-control">
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<label for="">Email1</label>
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<input type="email" class="form-control" name="registeredEmail1" placeholder="Email1">
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</div>
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<p>Example:- xyz.hsps@gmail.com</p>
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<div class="form-group float-label-control">
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<label for="">Email2</label>
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<input type="email" class="form-control" name="registeredEmail2" placeholder="Email2">
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</div>
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<h4 class="page-header">3. Type of Business Entity</h4>
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<div class="funkyradio">
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<div class="funkyradio-primary">
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<input type="radio" name="bEntity" id="radio1" value="SaleProprietorship" required>
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<label for="radio1">Sale Proprietorship</label>
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</div>
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<div class="funkyradio-primary">
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<input type="radio" name="bEntity" id="radio2" value="Partnership" required>
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<label for="radio2">Partnership</label>
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</div>
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<div class="funkyradio-primary">
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<input type="radio" name="bEntity" id="radio3" value="PrivateLimitedCompany" required>
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<label for="radio3">Private Limited company</label>
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</div>
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<div class="funkyradio-primary">
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<input type="radio" name="bEntity" id="radio4" value="LimitedLiabilityPartnership" required>
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<label for="radio4">Limited Liability Partnership</label>
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</div>
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</div>
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<div class ="Entity">
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<div class="SaleProprietorship box" id ="saleSaleProprietorship">Upload <strong>Proprietership proof</strong></div>
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<div class="partnership box" id="salePartnership">Upload <strong>Partnership Deed</strong></div>
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</div>
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<div class="limitedcompany box" id="salePrivateLimitedCompany">
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<div class="form-group float-label-control">
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<label for="">DIN Number</label>
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rajender |
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<input type="text" class="form-control" name="dinNumber" placeholder="DIN Number">
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</div>Upload <strong>Incorporation certificate,Memorandum & Article of association</strong>
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</div>
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<div class="LimitedLiabilityPartnership box" id="saleLimitedLiabilityPartnership">
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<div class="form-group float-label-control">
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<label for="">DIN Number</label>
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rajender |
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<input type="text" class="form-control" name="dinNumber" placeholder="DIN Number">
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</div>Upload <strong>Registration certificate & partnership Deed</strong>
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</div>
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<div class = "form-group file upload">
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rajender |
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<input type="file" accept="application/pdf,image/*" name = "bEntityDoc">
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</div>
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<h4 class="page-header">4. Goods And Services Tax Number(GST)</h4>
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<div class="Pmpform">
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<input type="text" name="gst" class="bform" placeholder="Goods And Services Tax Number"/>
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</div>
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<p>Provide Copy of GST document</p>
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<div class = "file upload">
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<input type="file" accept="application/pdf,image/*" name ="gstDoc">
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</div>
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<h4 class="page-header">5. Permanent Account Number(Pan)</h4>
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<div class="form-group ">
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<label for=""></label>
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rajender |
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<input type="text" name="pan" maxlength="10" class="bform" placeholder="Permanent Account Number"/></div>
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<p>Provide Copy of Pan </p>
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<div class = "form-group file upload">
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<input type="file" accept="application/pdf,image/*" name="panDoc">
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</div>
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<h4 class="page-header">6. Full Details Of BusinessEntity</h4>
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<div class="funkyradio">
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297 |
<div class="funkyradio-primary">
|
| 21822 |
rajender |
298 |
<input type="radio" name="bPmpDetail" id="business1" value="Proprietor" required>
|
| 21817 |
kshitij.so |
299 |
<label for="business1">Proprietor</label>
|
|
|
300 |
</div>
|
|
|
301 |
<div class="funkyradio-primary">
|
| 21822 |
rajender |
302 |
<input type="radio" name="bPmpDetail" id="business2" value="Partners" required>
|
| 21817 |
kshitij.so |
303 |
<label for="business2">Partners</label>
|
|
|
304 |
</div>
|
|
|
305 |
<div class="funkyradio-primary">
|
| 21822 |
rajender |
306 |
<input type="radio" name="bPmpDetail" id="business3" value="Directors" required>
|
| 21817 |
kshitij.so |
307 |
<label for="business3">Directors</label>
|
|
|
308 |
</div>
|
|
|
309 |
</div>
|
|
|
310 |
|
|
|
311 |
<div class="tablecontainer">
|
|
|
312 |
<table class="businessdetail">
|
|
|
313 |
<tr>
|
|
|
314 |
<th class ="PMPName">Name</th>
|
|
|
315 |
<th class="PMPAddress">Home Address</th>
|
|
|
316 |
<th class="PMPtelno">Mobile</th>
|
|
|
317 |
<th class="PMPpan">Pan</th>
|
|
|
318 |
<th class="PMPAdhaar">Adhaar</th>
|
|
|
319 |
<th class="PMPemail">Email</th>
|
|
|
320 |
<th class="PMPownership">Share %</th>
|
|
|
321 |
|
|
|
322 |
</tr>
|
|
|
323 |
<tr>
|
|
|
324 |
|
| 21822 |
rajender |
325 |
<td class="form-group"><input type="text" name="proprietorBusineesName"size="25"></td>
|
|
|
326 |
<td class="form-group"><textarea row="3" name="proprietorAddress"></textarea></td>
|
|
|
327 |
<td class="form-group"><input type="text" name="proprietorPhone" maxlength="10" pattern="[0-9]{10}"size="10"></th>
|
|
|
328 |
<td class="form-group"><input type="text" name="proprietorPan" maxlength="10" title="Please enter correct pan number"size="10"></td>
|
|
|
329 |
<td class="form-group"><input type="text" name= "proprietorAdhaar" size="15"></td>
|
|
|
330 |
<td class="form-group"><input type="email" name= "proprietorEmail" size="20"></td>
|
|
|
331 |
<td class="form-group"><input type="text" pattern="[0-9]" name="proprietorOwner" size="10"></td>
|
| 21817 |
kshitij.so |
332 |
|
|
|
333 |
</tr>
|
|
|
334 |
|
|
|
335 |
|
|
|
336 |
</table>
|
|
|
337 |
|
|
|
338 |
</div>
|
|
|
339 |
<div class="Partners pmp" id= "PmpPartners">
|
|
|
340 |
<table class="businessdetail">
|
|
|
341 |
|
|
|
342 |
<tr>
|
|
|
343 |
<th class ="PMPName">Name</th>
|
|
|
344 |
<th class="PMPAddress">Home Address</th>
|
|
|
345 |
<th class="PMPtelno">Mobile</th>
|
|
|
346 |
<th class="PMPpan">Pan</th>
|
|
|
347 |
<th class="PMPAdhaar">Adhaar</th>
|
|
|
348 |
<th class="PMPemail">Email </th>
|
|
|
349 |
<th class="PMPownership">Share %</th>
|
|
|
350 |
|
|
|
351 |
</tr>
|
|
|
352 |
<tr>
|
|
|
353 |
|
|
|
354 |
<td class="form-group"><input name="partnerName1"type="text" size="25"></td>
|
|
|
355 |
<td class="form-group"><textarea name="partnerAddress1" type="text" size="60"></textarea></td>
|
| 21822 |
rajender |
356 |
<td class="form-group"><input name = "partnerPhone1" pattern="[0-9]{10}"type="text" size="10"></th>
|
|
|
357 |
<td class="form-group"><input name ="partnerPan1"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
|
|
|
358 |
<td class="form-group"><input name="partnerAdhaar1" type="text" size="15"></td>
|
|
|
359 |
<td class="form-group"><input name="partnerEmail1" type="email" size="20"></td>
|
|
|
360 |
<td class="form-group"><input name="partnerOwner1" type="text"pattern="[0-9]"size="10"></td>
|
| 21817 |
kshitij.so |
361 |
|
|
|
362 |
</tr>
|
|
|
363 |
|
|
|
364 |
|
|
|
365 |
</table>
|
|
|
366 |
|
|
|
367 |
<table class="businessdetail">
|
|
|
368 |
|
|
|
369 |
<tr>
|
|
|
370 |
<th class ="PMPName">Name</th>
|
|
|
371 |
<th class="PMPAddress">Home Address</th>
|
|
|
372 |
<th class="PMPtelno">Mobile</th>
|
|
|
373 |
<th class="PMPpan">Pan</th>
|
|
|
374 |
<th class="PMPAdhaar">Adhaar</th>
|
|
|
375 |
<th class="PMPemail">Email </th>
|
|
|
376 |
<th class="PMPownership">Share %</th>
|
|
|
377 |
|
|
|
378 |
</tr>
|
|
|
379 |
<tr>
|
|
|
380 |
|
|
|
381 |
<td class="form-group"><input name="partnerName2"type="text" size="25"></td>
|
|
|
382 |
<td class="form-group"><textarea name="partnerAddress2" type="text" size="60"></textarea></td>
|
| 21822 |
rajender |
383 |
<td class="form-group"><input name = "partnerPhone2" pattern="[0-9]{10}" type="text" size="10"></th>
|
|
|
384 |
<td class="businesspan"><input name ="partnerPan2"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
|
|
|
385 |
<td class="form-group"><input name="partnerAdhaar2" type="text" size="15"></td>
|
|
|
386 |
<td class="form-group"><input name="partnerEmail2" type="email" size="20"></td>
|
|
|
387 |
<td class="form-group"><input name="partnerOwner2" pattern="[0-9]" type="text" size="10"></td>
|
| 21817 |
kshitij.so |
388 |
|
|
|
389 |
</tr>
|
|
|
390 |
|
|
|
391 |
</table>
|
|
|
392 |
<table class="businessdetail">
|
|
|
393 |
<tr>
|
|
|
394 |
<th class ="PMPName">Name</th>
|
|
|
395 |
<th class="PMPAddress">Home Address</th>
|
|
|
396 |
<th class="PMPtelno">Mobile</th>
|
|
|
397 |
<th class="PMPpan">Pan</th>
|
|
|
398 |
<th class="PMPAdhaar">Adhaar</th>
|
|
|
399 |
<th class="PMPemail">Email </th>
|
|
|
400 |
<th class="PMPownership">Share %</th>
|
|
|
401 |
|
|
|
402 |
</tr>
|
|
|
403 |
<tr>
|
|
|
404 |
|
|
|
405 |
<td class="form-group"><input name="partnerName3"type="text" size="25"></td>
|
|
|
406 |
<td class="form-group"><textarea name="partnerAddress3" type="text" size="60"></textarea></td>
|
| 21822 |
rajender |
407 |
<td class="form-group"><input name = "partnerPhone3" type="text" maxlength = "10" pattern="[0-9]{10}" size="10"></th>
|
|
|
408 |
<td class="form-group"><input name ="partnerPan3"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
|
|
|
409 |
<td class="form-groupr"><input name="partnerAdhaar3" type="text" size="15"></td>
|
|
|
410 |
<td class="form-group"><input name="partnerEmail3" type="email" size="20"></td>
|
|
|
411 |
<td class="form-group"><input name="partnerOwner3" pattern="[0-9" type="text" size="10"></td>
|
| 21817 |
kshitij.so |
412 |
|
|
|
413 |
</tr>
|
|
|
414 |
|
|
|
415 |
|
|
|
416 |
</table>
|
|
|
417 |
|
|
|
418 |
|
|
|
419 |
|
|
|
420 |
<table class="businessdetail">
|
|
|
421 |
<tr>
|
|
|
422 |
<th class ="PMPName">Name</th>
|
|
|
423 |
<th class="PMPAddress">Home Address</th>
|
|
|
424 |
<th class="PMPtelno">Mobile</th>
|
|
|
425 |
<th class="PMPpan">Pan</th>
|
|
|
426 |
<th class="PMPAdhaar">Adhaar</th>
|
|
|
427 |
<th class="PMPemail">Email </th>
|
|
|
428 |
<th class="PMPownership">Share %</th>
|
|
|
429 |
|
|
|
430 |
</tr>
|
|
|
431 |
<tr>
|
|
|
432 |
|
|
|
433 |
<td class="form-group"><input name="partnerName4"type="text" size="25"></td>
|
|
|
434 |
<td class="form-group"><textarea name="partnerAddress4" type="text" size="60"></textarea></td>
|
| 21822 |
rajender |
435 |
<td class="form-group"><input name = "partnerPhone4" pattern="[0-9]{10}" type="text" size="10"></th>
|
|
|
436 |
<td class="form-group"><input name ="partnerPan4"type="text" maxlength = "10"title="Please enter correct pan number"size="10"></td>
|
|
|
437 |
<td class="form-group"><input name="partnerAdhaar4" type="text" size="15"></td>
|
|
|
438 |
<td class="form-group"><input name="partnerEmail4" type="email" size="20"></td>
|
|
|
439 |
<td class="form-group"><input name="partnerOwner4" pattern="[0-9]" type="text" size="10"></td>
|
| 21817 |
kshitij.so |
440 |
|
|
|
441 |
</tr>
|
|
|
442 |
|
|
|
443 |
|
|
|
444 |
</table>
|
|
|
445 |
|
|
|
446 |
</div>
|
|
|
447 |
|
|
|
448 |
|
|
|
449 |
<div class="Directors pmp" id= "PmpDirectors">
|
|
|
450 |
<table class="businessdetail">
|
|
|
451 |
<tr>
|
|
|
452 |
<th class ="PMPName">Name</th>
|
|
|
453 |
<th class="PMPAddress">Home Address</th>
|
|
|
454 |
<th class="PMPtelno">Mobile</th>
|
|
|
455 |
<th class="PMPpan">Pan</th>
|
|
|
456 |
<th class="PMPAdhaar">Adhaar</th>
|
|
|
457 |
<th class="PMPemail">Email </th>
|
|
|
458 |
<th class="PMPownership">Share %</th>
|
|
|
459 |
|
|
|
460 |
</tr>
|
|
|
461 |
<tr>
|
|
|
462 |
<td class="form-group"><input name="shareholderName1"type="text" size="25"></td>
|
|
|
463 |
<td class="form-group"><textarea name="shareholderAddress1" type="text" size="60"></textarea></td>
|
| 21822 |
rajender |
464 |
<td class="form-group"><input name = "shareholderPhone1" pattern="[0-9]{10}" type="text" size="10"></th>
|
|
|
465 |
<td class="form-group"><input name ="shareholderPan1"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
|
|
|
466 |
<td class="form-group"><input name="shareholderAdhaar1" type="text" size="15"></td>
|
|
|
467 |
<td class="form-group"><input name="shareholderEmail1" type="email" size="20"></td>
|
|
|
468 |
<td class="form-group"><input name="shareholderOwner1" pattern="[0-9]" type="text" size="10"></td>
|
| 21817 |
kshitij.so |
469 |
|
|
|
470 |
</tr>
|
|
|
471 |
|
|
|
472 |
|
|
|
473 |
</table>
|
|
|
474 |
|
|
|
475 |
<table class="businessdetail">
|
|
|
476 |
<tr>
|
|
|
477 |
<th class ="PMPName">Name</th>
|
|
|
478 |
<th class="PMPAddress">Home Address</th>
|
|
|
479 |
<th class="PMPtelno">Mobile</th>
|
|
|
480 |
<th class="PMPpan">Pan</th>
|
|
|
481 |
<th class="PMPAdhaar">Adhaar</th>
|
|
|
482 |
<th class="PMPemail">Email </th>
|
|
|
483 |
<th class="PMPownership">Share %</th>
|
|
|
484 |
|
|
|
485 |
</tr>
|
|
|
486 |
<tr>
|
|
|
487 |
<td class="form-group"><input name="shareholderName2"type="text" size="25"></td>
|
|
|
488 |
<td class="form-group"><textarea name="shareholderAddress2" type="text" size="60"></textarea></td>
|
| 21822 |
rajender |
489 |
<td class="form-group"><input name = "shareholderPhone2" pattern="[0-9]{10}" type="text" size="10"></th>
|
|
|
490 |
<td class="form-group"><input name ="shareholderPan2"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
|
|
|
491 |
<td class="form-group"><input name="shareholderAdhaar2" type="text" size="15"></td>
|
|
|
492 |
<td class="form-group"><input name="shareholderEmail2" type="email" size="20"></td>
|
|
|
493 |
<td class="form-group"><input name="shareholderOwner2" pattern="[0-9]" type="text" size="10"></td>
|
| 21817 |
kshitij.so |
494 |
|
|
|
495 |
</tr>
|
|
|
496 |
</table>
|
|
|
497 |
|
|
|
498 |
<table class="businessdetail">
|
|
|
499 |
<tr>
|
|
|
500 |
<th class ="PMPName">Name</th>
|
|
|
501 |
<th class="PMPAddress">Home Address</th>
|
|
|
502 |
<th class="PMPtelno">Mobile</th>
|
|
|
503 |
<th class="PMPpan">Pan</th>
|
|
|
504 |
<th class="PMPAdhaar">Adhaar</th>
|
|
|
505 |
<th class="PMPemail">Email </th>
|
|
|
506 |
<th class="PMPownership">Share %</th>
|
|
|
507 |
|
|
|
508 |
</tr>
|
|
|
509 |
<tr>
|
|
|
510 |
<td class="form-group"><input name="shareholderName3"type="text" size="25"></td>
|
|
|
511 |
<td class="form-group"><textarea name="shareholderAddress3" type="text" size="60"></textarea></td>
|
| 21822 |
rajender |
512 |
<td class="form-group"><input name = "shareholderPhone3" pattern="[0-9]{10}" type="text" size="10"></th>
|
|
|
513 |
<td class="form-group"><input name ="shareholderPan3" type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
|
|
|
514 |
<td class="form-group"><input name="shareholderAdhaar3" type="text" size="15"></td>
|
|
|
515 |
<td class="form-group"><input name="shareholderEmail3" type="email" size="20"></td>
|
|
|
516 |
<td class="form-group"><input name="shareholderOwner3" pattern="[0-9]" type="text" size="10"></td>
|
| 21817 |
kshitij.so |
517 |
|
|
|
518 |
</tr>
|
|
|
519 |
|
|
|
520 |
</table>
|
|
|
521 |
|
|
|
522 |
<table class="businessdetail">
|
|
|
523 |
<tr>
|
|
|
524 |
<th class ="PMPName">Name</th>
|
|
|
525 |
<th class="PMPAddress">Home Address</th>
|
|
|
526 |
<th class="PMPtelno">Mobile</th>
|
|
|
527 |
<th class="PMPpan">Pan</th>
|
|
|
528 |
<th class="PMPAdhaar">Adhaar</th>
|
|
|
529 |
<th class="PMPemail">Email </th>
|
|
|
530 |
<th class="PMPownership">Share %</th>
|
|
|
531 |
|
|
|
532 |
</tr>
|
|
|
533 |
<tr>
|
| 21825 |
kshitij.so |
534 |
<td class="form-group"><input name="shareholderName4" type="text" size="25"></td>
|
| 21817 |
kshitij.so |
535 |
<td class="form-group"><textarea name="shareholderAddress4" type="text" size="60"></textarea></td>
|
| 21825 |
kshitij.so |
536 |
<td class="form-group"><input name = "shareholderPhone4" type="text" pattern="[0-9]{10}" size="10"></th>
|
|
|
537 |
<td class="form-group"><input name ="shareholderPan4" type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
|
|
|
538 |
<td class="form-group"><input name="shareholderAdhaar4" type="text" size="15"></td>
|
| 21822 |
rajender |
539 |
<td class="form-group"><input name="shareholderEmail4" type="email" size="20"></td>
|
|
|
540 |
<td class="form-group"><input name="shareholderOwner4" pattern="[0-9]" type="text" size="10"></td>
|
| 21817 |
kshitij.so |
541 |
|
|
|
542 |
</tr>
|
|
|
543 |
|
|
|
544 |
|
|
|
545 |
</table>
|
|
|
546 |
|
|
|
547 |
</div>
|
|
|
548 |
|
|
|
549 |
<h4 class="page-header">7. Store Manager Detail</h4>
|
|
|
550 |
|
|
|
551 |
|
|
|
552 |
<div class="form-group">
|
|
|
553 |
<label for="">Name
|
| 21822 |
rajender |
554 |
<input type="text" name="managerName"placeholder="Name"></label>
|
| 21817 |
kshitij.so |
555 |
<label for="">Mobile
|
| 21822 |
rajender |
556 |
<input type="text" name="managerNo" pattern="[0-9]{10}" title="Please enter Valid Mobile number" placeholder="Mobile No"> </label>
|
| 21817 |
kshitij.so |
557 |
<label for="">Email
|
| 21822 |
rajender |
558 |
<input type="email" name="managerEmail"size="25px" placeholder="Emailid"> </label>
|
| 21817 |
kshitij.so |
559 |
|
|
|
560 |
</div>
|
|
|
561 |
|
|
|
562 |
|
|
|
563 |
<h4 class="page-header">8. Manpower Details</h4>
|
|
|
564 |
|
|
|
565 |
<div class="form-group">
|
|
|
566 |
<label for="">Number of Employees
|
| 21822 |
rajender |
567 |
<input type="text" " pattern="[0-9]" name="noOfEmployees"placeholder="Number of Employees"></label>
|
| 21817 |
kshitij.so |
568 |
<label for="">Management Staff
|
| 21822 |
rajender |
569 |
<input type="text" " pattern="[0-9]" name="managementStaff" placeholder="Management Staff"> </label>
|
| 21817 |
kshitij.so |
570 |
|
|
|
571 |
</div>
|
|
|
572 |
|
|
|
573 |
<h4 class="page-header">9. Experience In Telecom Trade/other Trade (Brand & Product Category)</h4>
|
|
|
574 |
<div class="bcontacts">
|
| 21822 |
rajender |
575 |
<textarea rows="4" name="experienceinTelecome"cols="50" placeholder="Describe yourself here..."></textarea>
|
| 21817 |
kshitij.so |
576 |
</div>
|
|
|
577 |
|
|
|
578 |
<h4 class="page-header">10. Description of Existing Business & Annual Turnover</h4>
|
|
|
579 |
<div class="bcontacts">
|
| 21822 |
rajender |
580 |
<textarea rows="4" name="descriptionofExistingBusiness"cols="50" placeholder="Describe yourself here..."></textarea>
|
| 21817 |
kshitij.so |
581 |
</div>
|
|
|
582 |
<p>Please Provide ITR of last Two years</p>
|
|
|
583 |
<div class = "form-group file upload">
|
| 21822 |
rajender |
584 |
<input type="file" accept="application/pdf,image/*" name ="itrDoc">
|
| 21817 |
kshitij.so |
585 |
</div>
|
|
|
586 |
|
|
|
587 |
|
|
|
588 |
<h4 class="page-header">11.Business Model</h4>
|
|
|
589 |
|
|
|
590 |
<div class="btn-group">
|
|
|
591 |
<label class="btn btn-default">
|
| 21822 |
rajender |
592 |
<input type="radio" name="businessModel" value="Retailer" required>
|
| 21817 |
kshitij.so |
593 |
<span>Retailer</span>
|
|
|
594 |
</label>
|
|
|
595 |
<label class="btn btn-default">
|
| 21822 |
rajender |
596 |
<input type="radio" name="businessModel" value="Distributor" required>
|
| 21817 |
kshitij.so |
597 |
<span>Distributor</span>
|
|
|
598 |
</label>
|
|
|
599 |
<label class="btn btn-default">
|
| 21822 |
rajender |
600 |
<input type="radio" name="businessModel" value="Franchises" required>
|
| 21817 |
kshitij.so |
601 |
<span>Franchises</span>
|
|
|
602 |
</label>
|
|
|
603 |
<label class="btn btn-default">
|
| 21822 |
rajender |
604 |
<input type="radio" name="businessModel" value="Other" required>
|
| 21817 |
kshitij.so |
605 |
<span>Other</span>
|
|
|
606 |
</label>
|
|
|
607 |
</div>
|
|
|
608 |
|
|
|
609 |
|
|
|
610 |
<h4 class="page-header">12. Selling Online (if yes, Please Specify Portal Names)</h4>
|
|
|
611 |
|
|
|
612 |
<div class="btn-group">
|
|
|
613 |
<label class="btn btn-default">
|
| 21822 |
rajender |
614 |
<input type="radio" name="sellingOnline" value="yes">
|
| 21817 |
kshitij.so |
615 |
<span>Yes</span>
|
|
|
616 |
</label>
|
|
|
617 |
<label class="btn btn-default">
|
| 21822 |
rajender |
618 |
<input type="radio" name="sellingOnline" value="no">
|
| 21817 |
kshitij.so |
619 |
<span>No</span>
|
|
|
620 |
</label>
|
|
|
621 |
</div>
|
|
|
622 |
<div class="form-group portal Names" id = "sellingyes">
|
|
|
623 |
<label>Portal Names</label>
|
|
|
624 |
<input type="text" name="portalName1" size="25">
|
|
|
625 |
<input type="text" name="portalName2" size="25">
|
|
|
626 |
<input type="text" name="portalName3" size="25">
|
|
|
627 |
</div>
|
|
|
628 |
<h4 class="page-header">13. Area of Shop(in sq Feet)</h4>
|
|
|
629 |
<div>
|
|
|
630 |
<div class="form-group">
|
|
|
631 |
<label>
|
|
|
632 |
|
|
|
633 |
<input type="number" name="east" placeholder="East(Sq Feet)">
|
|
|
634 |
<input type="number" name="west" placeholder="West(Sq Feet)">
|
| 21822 |
rajender |
635 |
<input type="number" name="north" placeholder="North(Sq Feet)">
|
| 21817 |
kshitij.so |
636 |
</label>
|
|
|
637 |
</div>
|
|
|
638 |
<br>
|
|
|
639 |
<div class="form-group">
|
|
|
640 |
<label>
|
|
|
641 |
|
|
|
642 |
<input type="number" name="south" placeholder="South(Sq Feet)">
|
|
|
643 |
<input type="number" name="front" placeholder="Front(Sq Feet)">
|
| 21822 |
rajender |
644 |
<input type="number" name="roadSize" placeholder="Road Size in Front(Sq Feet)">
|
| 21817 |
kshitij.so |
645 |
|
|
|
646 |
</label>
|
|
|
647 |
</div>
|
|
|
648 |
|
|
|
649 |
</div>
|
|
|
650 |
<div class="shopArea">
|
|
|
651 |
<div class="btn-group">
|
|
|
652 |
<label class="btn btn-default">
|
|
|
653 |
<input type="radio" name="shopArea" value="Singleside">
|
|
|
654 |
<span>Single Side</span>
|
|
|
655 |
</label>
|
|
|
656 |
<label class="btn btn-default">
|
|
|
657 |
<input type="radio" name="shopArea" value"Twoside">
|
|
|
658 |
<span>Two Side</span>
|
|
|
659 |
</label>
|
|
|
660 |
<label class="btn btn-default">
|
|
|
661 |
<input type="radio" name="shopArea" value="Corner">
|
|
|
662 |
<span>Corner</span>
|
|
|
663 |
</label>
|
|
|
664 |
</div>
|
|
|
665 |
</div>
|
|
|
666 |
|
|
|
667 |
|
|
|
668 |
<h4 class="page-header">14. Status of Shop</h4>
|
|
|
669 |
|
|
|
670 |
<div class="btn-group">
|
|
|
671 |
<label class="btn btn-default">
|
| 21822 |
rajender |
672 |
<input type="radio" name="shopStatus" value="semifurnished">
|
| 21817 |
kshitij.so |
673 |
<span>Semi Furnished</span>
|
|
|
674 |
</label>
|
|
|
675 |
<label class="btn btn-default">
|
| 21822 |
rajender |
676 |
<input type="radio" name="shopStatus" value="fullfurnished">
|
| 21817 |
kshitij.so |
677 |
<span>Full Furnished</span>
|
|
|
678 |
</label>
|
|
|
679 |
</div>
|
|
|
680 |
|
|
|
681 |
<div class="checkboxes status" id ="shopsemifurnished">
|
|
|
682 |
<div class="btn btn-default">
|
|
|
683 |
<label for="success" class="btn btn-success">Flooring<input type="checkbox" name="flooring"
|
|
|
684 |
value ="flooring" id="success" class="badgebox"><span class="badge">✓</span></label>
|
|
|
685 |
<label for="warning" class="btn btn-success">Cieling<input type="checkbox" name="cieling" value="Pantry" id="warning" class="badgebox"><span class="badge">✓</span></label>
|
|
|
686 |
</div>
|
|
|
687 |
</div>
|
|
|
688 |
|
|
|
689 |
<div class ="checkboxes status" id ="shopfullfurnished">
|
|
|
690 |
<div class="row text-center">
|
|
|
691 |
<label for="default" class="btn btn-success">Store <input type="checkbox" name="shopStore" value="Store" id="default" class="badgebox"><span class="badge">✓</span></label>
|
|
|
692 |
<label for="primary" class="btn btn-success">Washroom <input type="checkbox" name="shopWashroom" value="Washroom"id="primary" class="badgebox"><span class="badge">✓</span></label>
|
|
|
693 |
<label for="info" class="btn btn-success">Water Supply<input type="checkbox" name="shopWater" value="Watersupply"id="info" class="badgebox"><span class="badge">✓</span></label>
|
|
|
694 |
<label for="success" class="btn btn-success">Electricity<input type="checkbox" name="shopElectricity"
|
|
|
695 |
value ="Electricity" id="success" class="badgebox"><span class="badge">✓</span></label>
|
|
|
696 |
<label for="warning" class="btn btn-success">Pantry<input type="checkbox" name="shopPantry" value="Pantry" id="warning" class="badgebox"><span class="badge">✓</span></label>
|
|
|
697 |
</div>
|
|
|
698 |
</div>
|
|
|
699 |
|
|
|
700 |
|
|
|
701 |
<h4 class="page-header">15. Shop Available At</h4>
|
|
|
702 |
|
|
|
703 |
<div class="btn-group">
|
|
|
704 |
<label class="btn btn-default">
|
|
|
705 |
<input type="radio" name="shopAvailbility" value="Basement">
|
|
|
706 |
<span>Basement</span>
|
|
|
707 |
</label>
|
|
|
708 |
<label class="btn btn-default">
|
|
|
709 |
<input type="radio" name="shopAvailbility" value="Groundfloor">
|
|
|
710 |
<span>Ground Floor</span>
|
|
|
711 |
</label>
|
|
|
712 |
<label class="btn btn-default">
|
|
|
713 |
<input type="radio" name="shopAvailbility" value="firstfloor">
|
|
|
714 |
<span>First Floor</span>
|
|
|
715 |
</label>
|
|
|
716 |
|
|
|
717 |
<label class="btn btn-default">
|
|
|
718 |
<input type="radio" name="shopAvailbility" value="secondfloor">
|
|
|
719 |
<span>Second Floor</span>
|
|
|
720 |
</label>
|
|
|
721 |
|
|
|
722 |
<label class="btn btn-default">
|
|
|
723 |
<input type="radio" name="shopAvailbility" value="thirdfloor">
|
|
|
724 |
<span>Third Floor</span>
|
|
|
725 |
</label>
|
|
|
726 |
</div>
|
|
|
727 |
|
|
|
728 |
<div class="form-group bdetail">
|
|
|
729 |
<p>Provide Pictures of the Shop From 3 different Angles and cieling and floorig</p>
|
| 21822 |
rajender |
730 |
<input type="file" name="angleDoc1" accept="application/pdf,image/*" >
|
|
|
731 |
<input type="file" name="angleDoc2" accept="application/pdf,image/*" >
|
|
|
732 |
<input type="file" name="angleDoc3" accept="application/pdf,image/*" >
|
|
|
733 |
<input type="file" name="angleDoc4" accept="application/pdf,image/*" >
|
|
|
734 |
<input type="file" name="angleDoc5" accept="application/pdf,image/*">
|
| 21817 |
kshitij.so |
735 |
</div>
|
|
|
736 |
|
|
|
737 |
<h4 class="page-header">16. Location of Shop</h4>
|
|
|
738 |
<div class="btn-group">
|
|
|
739 |
<label class="btn btn-default">
|
|
|
740 |
<input type="radio" name="location" value="shoppingMall">
|
|
|
741 |
<span>Shopping Mall</span>
|
|
|
742 |
</label>
|
|
|
743 |
<label class="btn btn-default">
|
|
|
744 |
<input type="radio" name="location" value="MainMobileMarket">
|
|
|
745 |
<span>Main Mobile Market</span>
|
|
|
746 |
</label>
|
|
|
747 |
<label class="btn btn-default">
|
|
|
748 |
<input type="radio" name="location" value="LocalMarket">
|
|
|
749 |
<span>Local Market</span>
|
|
|
750 |
</label>
|
|
|
751 |
|
|
|
752 |
</div>
|
|
|
753 |
|
|
|
754 |
|
|
|
755 |
|
|
|
756 |
<h4 class="page-header">17.Nearest Mobile Store</h4>
|
|
|
757 |
<div class="btn-group">
|
|
|
758 |
<label class="btn btn-default">
|
| 21822 |
rajender |
759 |
<input type="radio" name="nearestStore" value="100mtrs">
|
| 21817 |
kshitij.so |
760 |
<span>100Mtrs</span>
|
|
|
761 |
</label>
|
|
|
762 |
<label class="btn btn-default">
|
| 21822 |
rajender |
763 |
<input type="radio" name="nearestStore" value="200mtrs">
|
| 21817 |
kshitij.so |
764 |
<span>200Mtrs</span>
|
|
|
765 |
</label>
|
|
|
766 |
<label class="btn btn-default">
|
| 21822 |
rajender |
767 |
<input type="radio" name="nearestStore" value="500mtrs">
|
| 21817 |
kshitij.so |
768 |
<span>500Mtrs</span>
|
|
|
769 |
</label>
|
|
|
770 |
|
|
|
771 |
</div>
|
|
|
772 |
|
|
|
773 |
<div class="form-group location">
|
|
|
774 |
<label>Name of the Shop</label>
|
| 21822 |
rajender |
775 |
<input type="text" size ="35" name="storeName">
|
| 21817 |
kshitij.so |
776 |
<br>
|
|
|
777 |
<br>
|
|
|
778 |
<label>Address of the Shop</label>
|
|
|
779 |
<input type="text" size ="65" name="storeAddress">
|
|
|
780 |
</div>
|
|
|
781 |
|
|
|
782 |
|
|
|
783 |
|
|
|
784 |
<h4 class="page-header">18. Ownership of shop</h4>
|
|
|
785 |
|
|
|
786 |
<div class="btn-group">
|
|
|
787 |
<label class="btn btn-default">
|
|
|
788 |
<input type="radio" name="ownership" value="Selfowned">
|
|
|
789 |
<span>Self Owned</span>
|
|
|
790 |
</label>
|
|
|
791 |
<label class="btn btn-default">
|
|
|
792 |
<input type="radio" name="ownership" value="Rented">
|
|
|
793 |
<span>Rented</span>
|
|
|
794 |
</label>
|
|
|
795 |
<label class="btn btn-default">
|
|
|
796 |
<input type="radio" name="ownership" value="lease">
|
|
|
797 |
<span>Lease</span>
|
|
|
798 |
</label>
|
|
|
799 |
</label>
|
|
|
800 |
<label class="btn btn-default">
|
|
|
801 |
<input type="radio" name="ownership" value="collaboration">
|
|
|
802 |
<span>Collaboration</span>
|
|
|
803 |
</label>
|
|
|
804 |
|
|
|
805 |
</div>
|
|
|
806 |
|
|
|
807 |
<div class="form-group bdetail">
|
|
|
808 |
<p>Provide relevant documents (Electricity bill/Rent Agreement/Lease Deed)to prove the status of ownership</p>
|
| 21822 |
rajender |
809 |
<input type="file" accept="application/pdf,image/*" name="ownershipDoc">
|
| 21817 |
kshitij.so |
810 |
</div>
|
|
|
811 |
|
|
|
812 |
|
|
|
813 |
<h4 class="page-header">19. Insurance of Shop (if yes,Please provide the copy of the same)</h4>
|
|
|
814 |
|
|
|
815 |
|
|
|
816 |
<div class="btn-group">
|
|
|
817 |
<label class="btn btn-default">
|
| 21822 |
rajender |
818 |
<input type="radio" name="insurance" value="yes">
|
| 21817 |
kshitij.so |
819 |
<span>Yes</span>
|
|
|
820 |
</label>
|
|
|
821 |
<label class="btn btn-default">
|
| 21822 |
rajender |
822 |
<input type="radio" name="insurance" value="no">
|
| 21817 |
kshitij.so |
823 |
<span>No</span>
|
|
|
824 |
</label>
|
|
|
825 |
</div>
|
|
|
826 |
|
|
|
827 |
<div class="form-group insurance doc" id= "docyes">
|
|
|
828 |
<p>Please provide copy of insurance document</p>
|
| 21822 |
rajender |
829 |
<input type="file" accept="application/pdf,image/*" name="insuranceDoc">
|
| 21817 |
kshitij.so |
830 |
</div>
|
|
|
831 |
|
|
|
832 |
|
|
|
833 |
<h4 class="page-header">20. Loan on shop (LAP/BL/CC/others)</h4>
|
|
|
834 |
|
|
|
835 |
<div class="btn-group">
|
|
|
836 |
<label class="btn btn-default">
|
|
|
837 |
<input type="radio" name="loan" value="yes">
|
|
|
838 |
<span>Yes</span>
|
|
|
839 |
</label>
|
|
|
840 |
<label class="btn btn-default">
|
|
|
841 |
<input type="radio" name="loan" value="no">
|
|
|
842 |
<span>No</span>
|
|
|
843 |
</label>
|
|
|
844 |
</div>
|
|
|
845 |
|
|
|
846 |
<div class="form-group loan document" id ="documentyes">
|
|
|
847 |
<p>Please provide current statement Letter</p>
|
| 21822 |
rajender |
848 |
<input type="file" accept="application/pdf,image/*" name="loanDoc">
|
| 21817 |
kshitij.so |
849 |
|
|
|
850 |
<p>Please provide current sanction Letter</p>
|
| 21822 |
rajender |
851 |
<input type="file" accept="application/pdf,image/*" name="sanctionDoc">
|
| 21817 |
kshitij.so |
852 |
</div>
|
|
|
853 |
|
|
|
854 |
|
|
|
855 |
<h4 class="page-header">21. Bank Name & Address</h4>
|
|
|
856 |
|
|
|
857 |
<div class="form-group float-label-control">
|
|
|
858 |
<label for="">Account Number</label>
|
| 21822 |
rajender |
859 |
<input type="text" name="accountNumber"class="form-control" placeholder="Account Number">
|
| 21817 |
kshitij.so |
860 |
</div>
|
|
|
861 |
<div class="form-group float-label-control">
|
|
|
862 |
<label for="">Bank Name</label>
|
| 21822 |
rajender |
863 |
<input type="text" name="bankName"class="form-control" placeholder="Bank Name">
|
| 21817 |
kshitij.so |
864 |
</div>
|
|
|
865 |
<div class="form-group float-label-control">
|
|
|
866 |
<label for="">IFSC Code</label>
|
| 21822 |
rajender |
867 |
<input type="text" name="ifscCode"class="form-control" placeholder="IFSC Code">
|
| 21817 |
kshitij.so |
868 |
</div>
|
|
|
869 |
<div class="form-group float-label-control">
|
|
|
870 |
<label for="">Branch Name</label>
|
| 21822 |
rajender |
871 |
<input type="text" name="branchName" class="form-control" placeholder="Branch Name">
|
| 21817 |
kshitij.so |
872 |
</div>
|
|
|
873 |
<div >
|
|
|
874 |
<p>Please Attach the copy of cancelled cheques</p>
|
|
|
875 |
<div class="form-group">
|
| 21822 |
rajender |
876 |
<input type="file" name="chequeCopy" accept="application/pdf,image/*">
|
| 21817 |
kshitij.so |
877 |
</div>
|
|
|
878 |
|
|
|
879 |
|
|
|
880 |
<h4 class="page-header">22. Advance Payment Amount</h4>
|
|
|
881 |
|
|
|
882 |
|
|
|
883 |
<div class ="Account">
|
|
|
884 |
<h5>Account Detail:-</h5>
|
|
|
885 |
<label>Account Name: New Spice Solutions Pvt Ltd</label><br>
|
|
|
886 |
<label>Bank Name: Indusind Bank Ltd.</label><br>
|
|
|
887 |
<label>Account No.:201000488351</label><br>
|
|
|
888 |
<label>Branch:M-56, Greater Kailash-II, Main Market New Delhi-110048</label><br>
|
|
|
889 |
<label>IFSC:INDB0000012</label><br>
|
|
|
890 |
</div>
|
|
|
891 |
<p>Please deposit amount of <strong> Rs 1 Lac </strong>as advance payment in following account through NEFT/RTGS and submit the UTR No
|
|
|
892 |
<div class="form-group float-label-control">
|
|
|
893 |
<label for="">UTR Number</label>
|
|
|
894 |
<input type="text" name="utr" class="form-control" placeholder="UTR No">
|
|
|
895 |
</div>
|
|
|
896 |
<p><b>Note:</b> Advance amount deposited shall be adjustable in the first billing. This amount is 100% refundable in case of failed verification/withdrawl of application.</p>
|
|
|
897 |
|
|
|
898 |
|
|
|
899 |
|
|
|
900 |
<div class="submit">
|
|
|
901 |
<button type="submit" class="btn btn-success btn-lg">Submit</button>
|
|
|
902 |
</div>
|
|
|
903 |
|
|
|
904 |
<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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<!-- <fieldset hidden disabled="disabled">
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<h4 class="page-header">PMP STORE REGISTRATION APPROVAL</h4>
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<p>(FOR OFFICE USE ONLY)</P>
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<div class=breg>
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<div class=bApproval>
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<label>Recommended by</label>
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<input type="text" name = "recommended"class="reg-control" size="50">
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</div>
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<br>
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<div class=bApproval>
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<label>Business Manager</label>
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<input type="text" name=" bManager" class="reg-control" size="50">
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</div>
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<br>
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<div class=bApproval>
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<label>Operations Manager</label>
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<input type="text"name="operation"class="reg-control" size="50">
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</div>
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<br>
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<div class=bApproval>
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<label>BusinessHeadCategoryHead</label>
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<input type="text" name="bhead"class="reg-control" size="50">
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</div>
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</div>
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</fieldset> -->
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</form>
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</div>
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</div>
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<div class="col-sm-4">
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<div class="panel panel-default">
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<div class="panel-body">
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<label>Email:care@profitmandi.com</label><br>
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<label>Contact:8588842949 </label><br>
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<label>Address:Spice knowledge park,Sector 125, Noida, Uttar Pradesh</label>
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</div>
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</div>
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</div>
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</div>
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</div>
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</body>
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</html>
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