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22095 kshitij.so 1
<html>
2
<head>
3
 
4
<script src="resources/fofo-form/js/jquery-1.10.2.min.js"></script>
5
<link rel="stylesheet" href="resources/fofo-form/css/bootstrap.min.css"/>
6
<link rel="stylesheet" type="text/css" href="resources/fofo-form/css/main.css"/>
7
<!-- Optional theme -->
8
<link rel="stylesheet" href="resources/fofo-form/css/bootstrap-theme.min.css" />
9
 
10
<!-- Latest compiled and minified JavaScript -->
11
<script src="resources/fofo-form/js/bootstrap.min.js"></script>
12
<script src="resources/fofo-form/js/bootstrapValidator.js"></script>
13
<script src="resources/fofo-form/js/reg.js"></script>
14
<script src="resources/fofo-form/js/reqformvalidator.js"></script>
15
<script src="resources/fofo-form/js/jquery.blockUI.js"></script>
16
<script type="text/javascript">
17
 $(document).ready(function(){
18
 
19
    $("input[name$='bEntity']").click(function() {
20
        var test1 = $(this).val();
21
       $(".box").hide();
22
       $('input[name=dinNumber]').each(function(){
23
         $(this).prop('disabled', true);
24
      });
25
 
26
       var dinNumberInput = $("#sale"+test1+ " input[name=dinNumber]");
27
       if (dinNumberInput.prop('disabled') == true){
28
            dinNumberInput.prop('disabled', false);
29
       } 
30
        $("#sale" + test1).show();
31
});
32
});
33
</script>
34
 
35
<script type="text/javascript">
36
$(document).ready(function(){
37
    $("input[name$='bPmpDetail']").click(function() {
38
        var test1 = $(this).val();
39
       $(".pmp").hide();
40
        $("#Pmp" + test1).show();
41
    });
42
});
43
 
44
</script>
45
 
46
<script type="text/javascript">
47
$(document).ready(function(){
48
    $("input[name$='shopStatus']").click(function() {
49
        var test1 = $(this).val();
50
          $("#shopsemifurnished, #shopfullfurnished").find("input[type=checkbox]").each(function(){
51
         $(this).prop('disabled', true);
52
    });
53
 
54
       $(".status").hide();
55
       $("#shop" + test1).show();
56
       $("#shop" + test1).find("input[type=checkbox]").prop('disabled', false);
57
 
58
 
59
 
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
    });
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: "http://shop2020.in:8080/profitmandi-web/document-upload",
107
	          type: 'POST',
108
	          data: formData,
109
	          	cache: false,
110
            contentType: false,
111
            processData: false,
112
	            processData: false,
113
	           success: function (data) {
114
	           console.log(data);
115
	           	hiddenInput = inputName.split("_")[1];
116
	           	var doc_id = 0;
117
	           	if (data.response.document_id == 0){
118
	           		alert(data.response.message);
119
	           		return;
120
	           	}
121
	               $('input[name="' + hiddenInput + '"]').val(data.response.document_id);
22145 amit.gupta 122
	               validator.validateField(hiddenInput);
22095 kshitij.so 123
	           }
124
	    });
125
	});
126
 
127
  });
128
});
129
 
130
function queryStringToJSON(queryString) {
131
 
132
 
133
  var pairs = queryString.split('&');
134
  var result = {};
135
  pairs.forEach(function(pair) {
136
    pair = pair.split('=');
137
    result[pair[0]] = decodeURIComponent(pair[1] || '');
138
 
139
  });
140
  return result;
141
}
142
 
143
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"}
144
 
145
function jQFormSerializeArrToJson(formSerializeArr){
146
 var jsonObj = {};
147
 jQuery.map( formSerializeArr, function( n, i ) {
148
     jsonObj[n.name] = n.value;
149
 });
150
 return jsonObj;
151
}
152
 
153
</script>
154
 
155
<style>
156
.loading-image {
157
position: fixed;
158
top: 50%;
159
left: 50%;
160
margin-top: -50px;
161
margin-left: -100px;
162
z-index: 100;
163
}
164
</style>
165
 
166
</head>
167
 
168
<body>
169
<div class="container">
170
    <div class="row">
171
         <div class ="header">   
172
		 <h3 class="header">HOTSPOT PARTNER STORE</h3>
173
         <h4 class="header">Powered by Profit Mandi (A Unit of Spice Group)</h4>
174
         </div>
175
 
176
        <div class="header">
177
            <h5 class="header">APPLICATION FOR REGISTRATION</h5>
178
       </div>  
179
        <hr />
180
 
181
        <div class="row">
182
            <div class="col-sm-8">
183
 
184
                <form role="form" name="myform" id ="form"  enctype="multipart/form-data"  data-toggle="validator" novalidate>
185
             <h4 class="page-header">1. Registered Business Name of HSPS (in Block Letters)</h4>
186
                     <div class="form-group ">
187
 
188
                     <label for=""></label>
189
                     <input type="text" name="registeredBusinessName" style="text-transform:uppercase;" id="demo" class="bform" placeholder="Business Name"/>
190
                     </div>
191
 
192
 
193
             <h4 class="page-header">2. Registered Address (In Block Letters)</h4>
194
 
195
                    <div class="form-group float-label-control">
196
                        <label for="">Line 1</label>
197
                        <input type="text" name ="line1" class="form-control" placeholder="Line 1">
198
                    </div>
199
                     <div class="form-group float-label-control">
200
                        <label for="">Line 2</label>
201
                        <input type="text" name ="line2"class="form-control" placeholder="Line 2">
202
                    </div>
203
                     <div class="form-group float-label-control">
204
                        <label for="">Line 3</label>
205
                        <input type="text" name="line3" class="form-control" placeholder="Line 3">
206
                    </div>
207
                     <div class="form-group float-label-control">
208
                        <label for="">City</label>
209
                        <input type="text" name="city" class="form-control" placeholder="City">
210
                    </div>
211
                      <div class="form-group float-label-control">
212
                        <label for="">District</label>
213
                        <input type="text" name="district" class="form-control" placeholder="District">
214
                    </div>
215
                     <div class="form-group float-label-control">
216
                        <label for="">Pincode</label>
217
                        <input  type="text" name="pincode" maxlength="6" class="form-control" pattern="[0-9]{6}" title="Please enter correct Pin Code"placeholder="Pincode">
218
                      </div>  
219
 
220
                     <div class="form-group float-label-control">
221
 
222
                      <select class="form-control" name = "state" placeholder="State">
223
                       <option value=" ">State</option>
224
                     <option value="Andaman and Nicobar Islands">Andaman and Nicobar Islands</option>
225
                            <option value="Andhra Pradesh">Andhra Pradesh</option>
226
                            <option value="Arunachal Pradesh">Arunachal Pradesh</option>
227
                            <option value="Assam">Assam</option>
228
                            <option value="Bihar">Bihar</option>
229
                            <option value="Chandigarh">Chandigarh</option>
230
                            <option value="Chhattisgarh">Chhattisgarh</option>
231
                            <option value="Dadra and Nagar Haveli">Dadra and Nagar Haveli</option>
232
                            <option value="Daman and Diu">Daman and Diu</option>
233
                            <option value="Delhi">Delhi</option>
234
                            <option value="Goa">Goa</option>
235
                            <option value="Gujarat">Gujarat</option>
236
                            <option value="Haryana">Haryana</option>
237
                            <option value="Himachal Pradesh">Himachal Pradesh</option>
238
                            <option value="Jammu and Kashmir">Jammu and Kashmir</option>
239
                            <option value="Jharkhand">Jharkhand</option>
240
                            <option value="Karnataka">Karnataka</option>
241
                            <option value="Kerala">Kerala</option>
242
                            <option value="Lakshadweep">Lakshadweep</option>
243
                            <option value="Madhya Pradesh">Madhya Pradesh</option>
244
                            <option value="Maharashtra">Maharashtra</option>
245
                            <option value="Manipur">Manipur</option>
246
                            <option value="Meghalaya">Meghalaya</option>
247
                            <option value="Mizoram">Mizoram</option>
248
                            <option value="Nagaland">Nagaland</option>
249
                            <option value="Orissa">Orissa</option>
250
                            <option value="Pondicherry">Pondicherry</option>
251
                            <option value="Punjab">Punjab</option>
252
                            <option value="Rajasthan">Rajasthan</option>
253
                            <option value="Sikkim">Sikkim</option>
254
                            <option value="Tamil Nadu">Tamil Nadu</option>
255
                            <option value="Tripura">Tripura</option>
256
                            <option value="Telangana">Telangana</option>
257
                            <option value="Uttaranchal">Uttaranchal</option>
258
                            <option value="Uttar Pradesh">Uttar Pradesh</option>
259
                            <option value="West Bengal">West Bengal</option>
260
                                              </select>
261
                    </div>
262
 
263
 
264
                      <div class="form-group float-label-control">
265
                        <label for="">Email1</label>
22139 amit.gupta 266
                        <input type="email" class="form-control" name="registeredEmail1" placeholder="Email1" readonly value="${email}">
22095 kshitij.so 267
                      </div>  
268
                         <p>Example:- xyz<strong>.hsps@gmail.com</strong></p>
269
 
270
 
271
 
272
                        <div class="form-group float-label-control">
273
                        <label for="">Email2</label>
274
                        <input type="email" class="form-control" name="registeredEmail2" placeholder="Email2">
275
                      </div> 
276
 
277
 
278
                       <div class="form-group float-label-control">
279
                        <label for="">Mobile</label>
280
                        <input  type="text" class="form-control" name="mobile" maxlength = "10" pattern="[0-9]{10}" title="Please enter valid Phone number" placeholder="Mobile">
281
                      </div>  
282
 
283
                    <label>Landline</label>
284
                      <div class="form-group Pmpform">
285
                      <input type="text" name="stdcode" maxlength = "5" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="STDcode"/> 
286
 
287
 
288
                      <input type="text" name="telephone" maxlength = "10" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="Telephone"/>
289
                      </div>
290
 
291
 
292
 
293
             <h4 class="page-header">3. Type of Business Entity</h4>
294
 
295
                   <div class="funkyradio">
296
 
297
                    <div class="funkyradio-primary">
298
                        <input type="radio" name="bEntity" id="radio1" value="SaleProprietorship" required>
299
                        <label for="radio1">Proprietor</label>
300
                    </div>
301
                    <div class="funkyradio-primary">
302
                        <input type="radio" name="bEntity" id="radio2" value="Partnership" required>
303
                        <label for="radio2">Partnership</label>
304
                    </div>
305
                    <div class="funkyradio-primary">
306
                        <input type="radio" name="bEntity" id="radio3" value="PrivateLimitedCompany" required>
307
                        <label for="radio3">Private Limited company</label>
308
                    </div>
309
                    <div class="funkyradio-primary">
310
                        <input type="radio" name="bEntity" id="radio4" value="LimitedLiabilityPartnership" required>
311
                        <label for="radio4">Limited Liability Partnership</label>
312
                    </div>
313
                </div>
314
                  <div class ="Entity">
315
                    <div class="SaleProprietorship box" id ="saleSaleProprietorship">Upload <strong>Proprietership proof</strong></div>
316
                     <div class="partnership box" id="salePartnership">Upload <strong>Partnership Deed</strong></div>
317
                     </div>
318
                      <div class="limitedcompany box" id="salePrivateLimitedCompany">
319
                      <div class="form-group float-label-control">
320
                        <label for="">DIN Number</label>
321
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number">
322
                    </div>Upload <strong>Incorporation certificate,Memorandum & Article of association</strong>
323
                      </div>
324
 
325
 
326
                      <div class="LimitedLiabilityPartnership box" id="saleLimitedLiabilityPartnership">
327
 
328
 
329
                           <div class="form-group float-label-control">
330
                        <label for="">DIN Number</label>
331
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number">
332
                    </div>Upload <strong>Registration certificate & partnership Deed</strong>
333
                     </div>
334
 
335
                    <div class = "form-group file upload"> 
336
                   <input type="file" accept="application/pdf,image/*" id="doc" name ="doc_bEntityDoc">
337
 
338
                   <input type="hidden" name="bEntityDoc"/>
339
                    </div>
340
 
341
                     <h4 class="page-header">4. Goods And Services Tax Number(GST)</h4>
342
                    <div class="Pmpform">
343
 
344
                        <input type="text" name="gst" class="bform" placeholder="Goods And Services Tax Number"/>
345
                    </div>
346
                     <p>Provide Copy of GST document</p>
347
                    <div class = "file upload"> 
348
                   <input type="file"  accept="application/pdf,image/*" name ="doc_gstDoc">
349
                     <input type="hidden" name="gstDoc"/>
350
                    </div>
351
 
352
 
353
                     <h4 class="page-header">5. Permanent Account Number(PAN)</h4>
354
                    <div class="form-group ">
355
 
356
                     <label for=""></label>
357
                     <input type="text" name="pan" maxlength="10" class="bform" placeholder="Permanent Account Number"/></div>
358
                     <p>Provide Copy of PAN </p>
359
 
360
                    <div class = "form-group file upload"> 
361
 
362
                   <input type="file" accept="application/pdf,image/*" name="doc_panDoc">
363
                     <input type="hidden" name="panDoc"/>
364
                    </div>
365
 
366
 
367
             <h4 class="page-header">6. Full Details Of Business Entity</h4>
368
 
369
                   <div class="funkyradio">
370
                    <div class="funkyradio-primary">
371
                        <input type="radio" name="bPmpDetail" id="business1" value="Proprietor" required>
372
                        <label for="business1">Proprietor</label>
373
                    </div>
374
                    <div class="funkyradio-primary">
375
                        <input type="radio" name="bPmpDetail" id="business2" value="Partners" required>
376
                        <label for="business2">Partners</label>
377
                    </div>
378
                    <div class="funkyradio-primary">
379
                        <input type="radio" name="bPmpDetail" id="business3" value="Directors" required>
380
                        <label for="business3">Directors</label>
381
                    </div>
382
                </div>
383
 
384
                <div class="tablecontainer">
385
   <table class="businessdetail">
386
              <tr> 
387
              <th class ="PMPName">Name</th>
388
              <th  class="PMPAddress">Address</th> 
389
              <th class="PMPtelno">Mobile</th>
390
              <th class="PMPpan">PAN</th>
391
              <th class="PMPAdhaar">Aadhaar Number</th>
392
              <th class="PMPemail">Email</th>
393
              <th class="PMPownership">Share %</th>
394
 
395
               </tr>
396
            <tr>
397
 
398
                   <td class="form-group"><input type="text" name="proprietorBusineesName"size="25"></td>
399
                   <td class="form-group"><textarea row="3" name="proprietorAddress"></textarea></td>
400
                   <td class="form-group"><input type="text" name="proprietorPhone" maxlength="10" pattern="[0-9]{10}"size="10"></th>
401
                   <td class="form-group"><input type="text" name="proprietorPan" maxlength="10" title="Please enter correct pan number"size="10"></td>
402
                    <td class="form-group"><input type="text"  name= "proprietorAdhaar" size="15"></td>
403
                   <td class="form-group"><input type="email"  name= "proprietorEmail" size="20"></td>
404
                   <td class="form-group"><input type="text" pattern="[0-9]" name="proprietorOwner" size="10"></td>
405
 
406
                   </tr>
407
 
408
 
409
            </table>
410
 
411
            </div>
412
            <div class="Partners pmp" id= "PmpPartners">
413
            <table class="businessdetail">
414
 
415
             <tr> 
416
              <th class ="PMPName">Name</th>
417
              <th  class="PMPAddress">Address</th> 
418
              <th class="PMPtelno">Mobile</th>
419
              <th class="PMPpan">PAN</th>
420
              <th class="PMPAdhaar">Aadhaar Number</th>
421
              <th class="PMPemail">Email</th>
422
              <th class="PMPownership">Share %</th>
423
 
424
               </tr>
425
                <tr>
426
 
427
                   <td class="form-group"><input name="partnerName1"type="text" size="25"></td>
428
                   <td class="form-group"><textarea name="partnerAddress1" type="text" size="60"></textarea></td>
429
                   <td class="form-group"><input name = "partnerPhone1" pattern="[0-9]{10}"type="text" size="10"></th>
430
                   <td class="form-group"><input  name ="partnerPan1"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
431
                    <td class="form-group"><input name="partnerAdhaar1" type="text"  size="15"></td>
432
                   <td class="form-group"><input name="partnerEmail1" type="email"  size="20"></td>
433
                   <td class="form-group"><input name="partnerOwner1" type="text"pattern="[0-9]"size="10"></td>
434
 
435
                   </tr>
436
 
437
 
438
            </table>
439
 
440
                   <table class="businessdetail">
441
 
442
             <tr> 
443
              <th class ="PMPName">Name</th>
444
              <th  class="PMPAddress">Address</th> 
445
              <th class="PMPtelno">Mobile</th>
446
              <th class="PMPpan">PAN</th>
447
              <th class="PMPAdhaar">Aadhaar Number</th>
448
              <th class="PMPemail">Email</th>
449
              <th class="PMPownership">Share %</th>
450
 
451
               </tr>
452
              <tr>
453
 
454
                   <td class="form-group"><input name="partnerName2"type="text" size="25"></td>
455
                   <td class="form-group"><textarea name="partnerAddress2" type="text" size="60"></textarea></td>
456
                   <td class="form-group"><input name = "partnerPhone2" pattern="[0-9]{10}" type="text" size="10"></th>
457
                   <td class="businesspan"><input  name ="partnerPan2"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
458
                   <td class="form-group"><input name="partnerAdhaar2" type="text" size="15"></td>
459
                   <td class="form-group"><input name="partnerEmail2" type="email" size="20"></td>
460
                   <td class="form-group"><input name="partnerOwner2" pattern="[0-9]" type="text" size="10"></td>
461
 
462
                   </tr>
463
 
464
            </table>
465
                   <table class="businessdetail">
466
             <tr> 
467
            <th class ="PMPName">Name</th>
468
              <th  class="PMPAddress">Address</th> 
469
              <th class="PMPtelno">Mobile</th>
470
              <th class="PMPpan">PAN</th>
471
              <th class="PMPAdhaar">Aadhaar Number</th>
472
              <th class="PMPemail">Email</th>
473
              <th class="PMPownership">Share %</th>
474
 
475
               </tr>
476
                 <tr>
477
 
478
                   <td class="form-group"><input name="partnerName3"type="text" size="25"></td>
479
                   <td class="form-group"><textarea name="partnerAddress3" type="text" size="60"></textarea></td>
480
                   <td class="form-group"><input name = "partnerPhone3" type="text"  maxlength = "10" pattern="[0-9]{10}"  size="10"></th>
481
                   <td class="form-group"><input  name ="partnerPan3"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
482
                    <td class="form-groupr"><input name="partnerAdhaar3" type="text" size="15"></td>
483
                   <td class="form-group"><input name="partnerEmail3"  type="email" size="20"></td>
484
                   <td class="form-group"><input name="partnerOwner3" pattern="[0-9"  type="text" size="10"></td>
485
 
486
                   </tr>
487
 
488
 
489
            </table>
490
 
491
 
492
 
493
           <table class="businessdetail">
494
       <tr> 
495
                <th class ="PMPName">Name</th>
496
              <th  class="PMPAddress">Address</th> 
497
              <th class="PMPtelno">Mobile</th>
498
              <th class="PMPpan">PAN</th>
499
              <th class="PMPAdhaar">Aadhaar Number</th>
500
              <th class="PMPemail">Email</th>
501
              <th class="PMPownership">Share %</th>
502
               </tr>
503
               <tr>
504
 
505
                   <td class="form-group"><input name="partnerName4"type="text" size="25"></td>
506
                   <td class="form-group"><textarea name="partnerAddress4" type="text" size="60"></textarea></td>
507
                   <td class="form-group"><input name = "partnerPhone4"  pattern="[0-9]{10}" type="text" size="10"></th>
508
                   <td class="form-group"><input  name ="partnerPan4"type="text" maxlength = "10"title="Please enter correct pan number"size="10"></td>
509
                    <td class="form-group"><input name="partnerAdhaar4" type="text" size="15"></td>
510
                   <td class="form-group"><input name="partnerEmail4" type="email" size="20"></td>
511
                   <td class="form-group"><input name="partnerOwner4" pattern="[0-9]" type="text" size="10"></td>
512
 
513
                   </tr>
514
 
515
 
516
            </table>
517
 
518
            </div>
519
 
520
 
521
             <div class="Directors pmp" id= "PmpDirectors">
522
            <table class="businessdetail">
523
               <tr> 
524
               <th class ="PMPName">Name</th>
525
              <th  class="PMPAddress">Address</th> 
526
              <th class="PMPtelno">Mobile</th>
527
              <th class="PMPpan">PAN</th>
528
              <th class="PMPAdhaar">Aadhaar Number</th>
529
              <th class="PMPemail">Email</th>
530
              <th class="PMPownership">Share %</th>
531
 
532
               </tr>
533
               <tr>
534
                   <td class="form-group"><input name="shareholderName1"type="text" size="25"></td>
535
                   <td class="form-group"><textarea name="shareholderAddress1" type="text" size="60"></textarea></td>
536
                   <td class="form-group"><input name = "shareholderPhone1" pattern="[0-9]{10}" type="text" size="10"></th>
537
                   <td class="form-group"><input  name ="shareholderPan1"type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
538
                   <td class="form-group"><input name="shareholderAdhaar1" type="text" size="15"></td>
539
                   <td class="form-group"><input name="shareholderEmail1" type="email" size="20"></td>
540
                   <td class="form-group"><input name="shareholderOwner1" pattern="[0-9]" type="text" size="10"></td>
541
 
542
                   </tr>
543
 
544
 
545
            </table>
546
 
547
                   <table class="businessdetail">
548
          <tr> 
549
                <th class ="PMPName">Name</th>
550
              <th  class="PMPAddress">Address</th> 
551
              <th class="PMPtelno">Mobile</th>
552
              <th class="PMPpan">PAN</th>
553
              <th class="PMPAdhaar">Aadhaar Number</th>
554
              <th class="PMPemail">Email</th>
555
              <th class="PMPownership">Share %</th>
556
               </tr>
557
                 <tr>
558
                   <td class="form-group"><input name="shareholderName2"type="text" size="25"></td>
559
                   <td class="form-group"><textarea name="shareholderAddress2" type="text" size="60"></textarea></td>
560
                   <td class="form-group"><input name = "shareholderPhone2" pattern="[0-9]{10}" type="text" size="10"></th>
561
                   <td class="form-group"><input  name ="shareholderPan2"type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
562
                    <td class="form-group"><input name="shareholderAdhaar2" type="text" size="15"></td>
563
                   <td class="form-group"><input name="shareholderEmail2"  type="email" size="20"></td>
564
                   <td class="form-group"><input name="shareholderOwner2" pattern="[0-9]"  type="text" size="10"></td>
565
 
566
                   </tr>
567
            </table>
568
 
569
                   <table class="businessdetail">
570
              <tr> 
571
                <th class ="PMPName">Name</th>
572
              <th  class="PMPAddress">Address</th> 
573
              <th class="PMPtelno">Mobile</th>
574
              <th class="PMPpan">PAN</th>
575
              <th class="PMPAdhaar">Aadhaar Number</th>
576
              <th class="PMPemail">Email</th>
577
              <th class="PMPownership">Share %</th>
578
 
579
               </tr>
580
                   <tr>
581
                   <td class="form-group"><input name="shareholderName3"type="text" size="25"></td>
582
                   <td class="form-group"><textarea name="shareholderAddress3" type="text" size="60"></textarea></td>
583
                   <td class="form-group"><input name = "shareholderPhone3" pattern="[0-9]{10}" type="text" size="10"></th>
584
                   <td class="form-group"><input  name ="shareholderPan3" type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
585
                   <td class="form-group"><input name="shareholderAdhaar3" type="text" size="15"></td>
586
                   <td class="form-group"><input name="shareholderEmail3" type="email" size="20"></td>
587
                   <td class="form-group"><input name="shareholderOwner3" pattern="[0-9]" type="text" size="10"></td>
588
 
589
                   </tr>
590
 
591
            </table>
592
 
593
                   <table class="businessdetail">
594
             <tr> 
595
                <th class ="PMPName">Name</th>
596
              <th  class="PMPAddress">Address</th> 
597
              <th class="PMPtelno">Mobile</th>
598
              <th class="PMPpan">PAN</th>
599
              <th class="PMPAdhaar">Aadhaar Number</th>
600
              <th class="PMPemail">Email</th>
601
              <th class="PMPownership">Share %</th>
602
               </tr>
603
                     <tr>
604
                   <td class="form-group"><input name="shareholderName4" type="text" size="25"></td>
605
                   <td class="form-group"><textarea name="shareholderAddress4" type="text" size="60"></textarea></td>
606
                   <td class="form-group"><input name = "shareholderPhone4" type="text" pattern="[0-9]{10}" size="10"></th>
607
                   <td class="form-group"><input  name ="shareholderPan4" type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
608
                    <td class="form-group"><input name="shareholderAdhaar4" type="text" size="15"></td>
609
                   <td class="form-group"><input name="shareholderEmail4"  type="email" size="20"></td>
610
                   <td class="form-group"><input name="shareholderOwner4" pattern="[0-9]"  type="text" size="10"></td>
611
 
612
                   </tr>
613
 
614
 
615
            </table>
616
 
617
            </div>
618
 
619
         <h4 class="page-header">7. Store Manager Details</h4>
620
 
621
 
622
                    <div class="form-group">
623
                    <label for="">Name
624
                    <input type="text" name="managerName"placeholder="Name"></label>
625
                    <label for="">Mobile
626
                        <input type="text" name="managerNo" pattern="[0-9]{10}" title="Please enter Valid Mobile number" placeholder="Mobile No"> </label>  
627
                    <label for="">Email
628
                        <input type="email" name="managerEmail"size="25px" placeholder="Emailid"> </label>  
629
 
630
                    </div>
631
 
632
 
633
            <h4 class="page-header">8. Manpower Details</h4>
634
 
635
               <div class="form-group">
636
                    <label for="">Number of Employees
637
                    <input type="text" pattern="[0-9]" name="noOfEmployees"placeholder="Number of Employees"></label>
638
                    <label for="">Number of Management Staff
639
                        <input type="text" pattern="[0-9]" name="managementStaff" placeholder="Management Staff"> </label>  
640
 
641
                    </div>
642
 
643
              <h4 class="page-header">9. Experience In Telecom Trade/other Trade (Brand & Product Category)</h4>
644
                <div class="bcontacts">
645
                   <textarea rows="4" name="experienceinTelecome"cols="50" placeholder="Describe yourself here..."></textarea> 
646
                </div>
647
 
648
            <h4 class="page-header">10. Description of Existing Business & Annual Turnover</h4>
649
                <div class="bcontacts">
650
                      <textarea rows="4" name="descriptionofExistingBusiness"cols="50" placeholder="Describe yourself here..."></textarea>
651
                </div>
652
                <p>Please Provide ITR of last Two years</p>
653
                <div class = "form-group file upload"> 
654
                   <input type="file" accept="application/pdf,image/*" name ="doc_itrDoc">
655
                      <input type="hidden" name="itrDoc"/>
656
                    </div>
657
 
658
 
659
            <h4 class="page-header">11.Business Model</h4>
660
 
661
            <div class="btn-group">
662
                    <label class="btn btn-default">
663
                   <input type="radio" name="businessModel" value="Retailer" required>
664
                   <span>Retailer</span>
665
                  </label>
666
                <label class="btn btn-default">
667
                    <input type="radio" name="businessModel" value="Distributor" required>
668
                    <span>Distributor</span>
669
                </label>
670
                <label class="btn btn-default">
671
                    <input type="radio" name="businessModel" value="Franchises" required>
672
                    <span>Franchise</span>
673
                </label>
674
                  <label class="btn btn-default">
675
                    <input type="radio" name="businessModel" value="Other" required>
676
                    <span>Other</span>
677
                </label>
678
              </div>
679
 
680
 
681
          <h4 class="page-header">12. Selling Online (if yes, please specify Portal Names)</h4>
682
 
683
                    <div class="btn-group">
684
                    <label class="btn btn-default">
685
                   <input type="radio" name="sellingOnline" value="yes">
686
                   <span>Yes</span>
687
                  </label>
688
                <label class="btn btn-default">
689
                    <input type="radio" name="sellingOnline" value="no">
690
                    <span>No</span>
691
                </label>
692
              </div>
693
                   <div class="form-group portal Names" id = "sellingyes">
694
                   <label>Portal Names</label>
695
                       <input type="text" name="portalName1" size="25">
696
                       <input type="text" name="portalName2" size="25">
697
                       <input type="text" name="portalName3" size="25">
698
                  </div>
699
            <h4 class="page-header">13. Area of Shop(in Sq Feet)</h4>
700
              <div>
701
                 <div class="form-group">
702
                    <label>
703
 
704
                    <input type="number" name="east"  placeholder="East(Sq Feet)">
705
                    <input type="number" name="west"  placeholder="West(Sq Feet)">
706
                    <input type="number" name="north" placeholder="North(Sq Feet)"> 
707
                    </label>
708
                </div>
709
                    <br>
710
                      <div class="form-group">
711
                    <label>
712
 
713
                    <input type="number" name="south" placeholder="South(Sq Feet)">
714
                    <input type="number" name="front" placeholder="Front(Sq Feet)">
715
                    <input type="number" name="roadSize" placeholder="Road Size in Front(Sq Feet)">
716
 
717
                    </label>
718
                </div>
719
 
720
                  </div>  
721
                  <div class="shopArea">
722
                   <div class="btn-group">
723
                    <label class="btn btn-default">
724
                   <input type="radio" name="shopArea" value="Singleside">
725
                   <span>Single Side</span>
726
                  </label>
727
                <label class="btn btn-default">
728
                    <input type="radio" name="shopArea" value"Twoside">
729
                    <span>Two Side</span>
730
                </label>
731
                  <label class="btn btn-default">
732
                    <input type="radio" name="shopArea" value="Corner">
733
                    <span>Corner</span>
734
                </label>
735
              </div>
736
              </div>
737
 
738
 
739
              <h4 class="page-header">14. Status of Shop</h4>
740
 
741
                 <div class="btn-group">
742
                    <label class="btn btn-default">
743
                   <input type="radio" name="shopStatus" value="semifurnished">
744
                   <span>Semi Furnished</span>
745
                  </label>
746
                <label class="btn btn-default">
747
                    <input type="radio" name="shopStatus" value="fullfurnished">
748
                    <span>Fully Furnished</span>
749
                </label>
750
                </div>
751
 
752
                 <div class="checkboxes status" id ="shopsemifurnished">
753
                 <div class="btn btn-default">
754
   <label for="success1" class="btn btn-success">Flooring<input type="checkbox" name="flooring" 
755
          value ="flooring" id="success1" class="badgebox"><span class="badge">&check;</span></label>
756
        <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>
757
 
758
 
759
              </div>
760
            </div>
761
 
762
<div class ="checkboxes status"  id ="shopfullfurnished">
763
          <div class="row text-center">
764
    <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>
765
        <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>
766
        <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>
767
        <label for="success" class="btn btn-success">Electricity<input type="checkbox" name="electricity" 
768
          value ="yes" id="success" class="badgebox"><span class="badge">&check;</span></label>
769
        <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>
770
  </div>
771
    </div>
772
 
773
 
774
              <h4 class="page-header">15. Shop Available At</h4>
775
 
776
                     <div class="btn-group">
777
                    <label class="btn btn-default">
778
                   <input type="radio" name="shopAvailbility" value="Basement">
779
                   <span>Basement</span>
780
                  </label>
781
                <label class="btn btn-default">
782
                    <input type="radio" name="shopAvailbility" value="Groundfloor">
783
                    <span>Ground Floor</span>
784
                </label>
785
                  <label class="btn btn-default">
786
                    <input type="radio" name="shopAvailbility" value="firstfloor">
787
                    <span>First Floor</span>
788
                </label>
789
 
790
                  <label class="btn btn-default">
791
                    <input type="radio" name="shopAvailbility" value="secondfloor">
792
                    <span>Second Floor</span>
793
                </label>
794
 
795
                 <label class="btn btn-default">
796
                    <input type="radio" name="shopAvailbility" value="thirdfloor">
797
                    <span>Third Floor</span>
798
                </label>
799
                </div>
800
 
801
                <div class="form-group bdetail">
802
                   <p>Provide pictures of the shop from 3 different angles, ceiling and flooring</p>
803
                      <input type="file" name="doc_angleDoc1" accept="application/pdf,image/*" >
804
                      <input type="hidden" name="angleDoc1"/>
805
                      <input type="file" name="doc_angleDoc2" accept="application/pdf,image/*" >
806
                      <input type="hidden" name="angleDoc2"/>
807
                      <input type="file" name="doc_angleDoc3"  accept="application/pdf,image/*" >
808
                      <input type="hidden" name="angleDoc3"/>
809
                      <input type="file" name="doc_angleDoc4"  accept="application/pdf,image/*" >
810
                      <input type="hidden" name="angleDoc4"/>
811
                      <input type="file" name="doc_angleDoc5" accept="application/pdf,image/*">
812
                      <input type="hidden" name="angleDoc5"/>
813
                  </div>
814
 
815
         <h4 class="page-header">16. Location of Shop</h4>
816
                        <div class="btn-group">
817
                    <label class="btn btn-default">
818
                   <input type="radio" name="location" value="shoppingMall">
819
                   <span>Shopping Mall</span>
820
                  </label>
821
                <label class="btn btn-default">
822
                    <input type="radio" name="location" value="MainMobileMarket">
823
                    <span>Main Mobile Market</span>
824
                </label>
825
                  <label class="btn btn-default">
826
                    <input type="radio" name="location" value="LocalMarket">
827
                    <span>Local Market</span>
828
                </label>
829
 
830
                </div>
831
 
832
 
833
 
834
             <h4 class="page-header">17.Nearest Mobile Store</h4>
835
                           <div class="btn-group">
836
                    <label class="btn btn-default">
837
                   <input type="radio" name="nearestStore" value="100mtrs">
838
                   <span>100Mtrs</span>
839
                  </label>
840
                <label class="btn btn-default">
841
                    <input type="radio" name="nearestStore" value="200mtrs">
842
                    <span>200Mtrs</span>
843
                </label>
844
                  <label class="btn btn-default">
845
                    <input type="radio" name="nearestStore" value="500mtrs">
846
                    <span>500Mtrs</span>
847
                </label>
848
 
849
                </div>
850
 
851
                 <div class="form-group location">
852
                   <label>Name of the Shop</label>
853
                       <input type="text" size ="35" name="storeName">
854
                       <br>
855
                       <br>
856
                        <label>Address of the Shop</label>
857
                       <input type="text" size ="65" name="storeAddress">
858
                  </div>
859
 
860
 
861
 
862
            <h4 class="page-header">18. Ownership of Shop</h4>
863
 
864
                    <div class="btn-group">
865
                    <label class="btn btn-default">
866
                   <input type="radio" name="ownership" value="Selfowned">
867
                   <span>Self Owned</span>
868
                  </label>
869
                <label class="btn btn-default">
870
                    <input type="radio" name="ownership" value="Rented">
871
                    <span>Rented</span>
872
                </label>
873
                  <label class="btn btn-default">
874
                    <input type="radio" name="ownership" value="lease">
875
                    <span>Lease</span>
876
                </label>
877
                  </label>
878
                  <label class="btn btn-default">
879
                    <input type="radio" name="ownership" value="collaboration">
880
                    <span>Collaboration</span>
881
                </label>
882
 
883
                </div>
884
 
885
                 <div class="form-group bdetail">
886
                   <p>Provide relevant documents (Electricity bill/Rent Agreement/Lease Deed)to prove the status of ownership</p>
887
                     <input type="file" accept="application/pdf,image/*" name="doc_ownershipDoc">
888
                     <input type="hidden" name="ownershipDoc"/>
889
                   </div>
890
 
891
 
892
           <h4 class="page-header">19. Insurance of Shop (if yes, please provide the copy of the same)</h4>
893
 
894
 
895
                    <div class="btn-group">
896
                    <label class="btn btn-default">
897
                   <input type="radio" name="insurance" value="yes">
898
                   <span>Yes</span>
899
                  </label>
900
                <label class="btn btn-default">
901
                    <input type="radio" name="insurance" value="no">
902
                    <span>No</span>
903
                </label>
904
              </div>
905
 
906
                 <div class="form-group insurance doc"  id= "docyes">
907
                  <p>Please provide copy of insurance document</p>
908
                     <input type="file" accept="application/pdf,image/*" name="doc_insuranceDoc">
909
                      <input type="hidden" name="insuranceDoc"/>
910
                   </div>
911
 
912
 
913
         <h4 class="page-header">20. Loan on Shop (LAP/BL/CC/others)</h4>
914
 
915
                     <div class="btn-group">
916
                    <label class="btn btn-default">
917
                   <input type="radio" name="loan" value="yes">
918
                   <span>Yes</span>
919
                  </label>
920
                <label class="btn btn-default">
921
                    <input type="radio" name="loan" value="no">
922
                    <span>No</span>
923
                </label>
924
              </div>
925
 
926
                 <div class="form-group loan document" id ="documentyes">
927
                  <p>Please provide current statement Letter</p>
928
                     <input type="file" accept="application/pdf,image/*" name="doc_loanDoc">
929
                     <input type="hidden" name="loanDoc"/>
930
                      <p>Please provide current sanction Letter</p>
931
                     <input type="file" accept="application/pdf,image/*" name="doc_sanctionDoc">
932
                     <input type="hidden" name="sanctionDoc"/>
933
                   </div>
934
 
935
 
936
            <h4 class="page-header">21. Bank Name & Address</h4>
937
 
938
                  <div class="form-group float-label-control">
939
                        <label for="">Account Number</label>
940
                        <input type="text" name="accountNumber"class="form-control" placeholder="Account Number">
941
                    </div>
942
                     <div class="form-group float-label-control">
943
                        <label for="">Bank Name</label>
944
                        <input type="text" name="bankName"class="form-control" placeholder="Bank Name">
945
                    </div>
946
                     <div class="form-group float-label-control">
947
                        <label for="">IFSC Code</label>
948
                        <input type="text" name="ifscCode"class="form-control" placeholder="IFSC Code">
949
                    </div>
950
                     <div class="form-group float-label-control">
951
                        <label for="">Branch Name</label>
952
                        <input type="text" name="branchName" class="form-control" placeholder="Branch Name">
953
                    </div>
954
                     <div >
955
                  <p>Please attach the copy of cancelled cheque</p>
956
                      <div class="form-group">
957
                     <input type="file" name="doc_chequeCopy" accept="application/pdf,image/*">
958
                     <input type="hidden" name="chequeCopy"/>
959
                   </div>
960
 
961
 
962
                  <h4 class="page-header">22. HSPS Bank Account Detail</h4> 
963
 
964
                  <p>Please deposit amount of <strong> Rs 1 Lac </strong>as advance payment in following account through NEFT and submit the UTR No.</p>
965
                    <div class="form-group float-label-control">
966
                        <label for="">UTR Number</label>
967
                        <input type="text" name="utr" class="form-control" placeholder="UTR No">
968
                    </div>
969
                    <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>
970
 
971
 
972
 
973
                      <div class ="Account">
974
                      <label>Account Name: New Spice Solutions Pvt Ltd</label><br>
975
                       <label>Bank Name: IndusInd Bank Ltd.</label><br>
976
                        <label>Account No.:201000488351</label><br>
977
                        <label>Branch:M-56, Greater Kailash-II, Main Market New Delhi-110048</label><br>
978
                         <label>IFSC:INDB0000012</label><br>
979
                        </div>
980
 
981
                <div class="submit">
982
                    <button type="submit" class="btn btn-success btn-lg">Submit</button>
983
                </div>
984
 
985
                <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>
986
 
987
 
988
 
989
 
990
 <!--             <fieldset hidden disabled="disabled">
991
              <h4 class="page-header">PMP STORE REGISTRATION APPROVAL</h4>
992
                 <p>(FOR OFFICE USE ONLY)</P>
993
 
994
                <div class=breg>
995
                 <div class=bApproval>
996
 
997
                  <label>Recommended by</label>
998
                  <input type="text" name = "recommended"class="reg-control" size="50">
999
 
1000
                  </div>
1001
                  <br>
1002
 
1003
                    <div class=bApproval>
1004
                  <label>Business Manager</label>
1005
                  <input type="text" name=" bManager" class="reg-control" size="50">
1006
                </div>
1007
                      <br>
1008
                        <div class=bApproval>
1009
                    <label>Operations Manager</label>
1010
                  <input type="text"name="operation"class="reg-control"  size="50">
1011
                </div>
1012
                  <br>
1013
               <div class=bApproval>
1014
                     <label>BusinessHeadCategoryHead</label>
1015
                  <input type="text" name="bhead"class="reg-control" size="50">
1016
                </div>
1017
 
1018
 
1019
                 </div>
1020
               </fieldset> -->
1021
 
1022
                      </form>
1023
                    </div>
1024
          </div>
1025
   <div class="col-sm-4">
1026
                <div class="panel panel-default">
1027
 
1028
                    <div class="panel-body">
1029
 
1030
 
1031
                   <label>Spice Global Knowledge Park - 6th Floor, Plot No.19A & 19B, Sector 125, Noida, UP - 201301</label>
1032
                   <br>
1033
                    <label>Email - care@profitmandi.com</<label>
1034
                    <br> 
1035
                    <label>Contact - 8588842949 </label>
1036
                    </div>
1037
                </div>
1038
            </div>
1039
 
1040
        </div>
1041
 
1042
    </div>
1043
    </div>
1044
</body>
1045
</html>