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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);
22148 amit.gupta 122
	               validator.data('bootstrapValidator').getInvalidFields()
22095 kshitij.so 123
	           }
124
	    });
125
	});
126
 
127
  });
128
});
129
 
130
function queryStringToJSON(queryString) {
131
  var pairs = queryString.split('&');
132
  var result = {};
133
  pairs.forEach(function(pair) {
134
    pair = pair.split('=');
135
    result[pair[0]] = decodeURIComponent(pair[1] || '');
136
 
137
  });
138
  return result;
139
}
140
 
22148 amit.gupta 141
/*var oResult ={Branchname: "jnkmk",DinNumber: "8327592895",ExperienceinTelecome: "kdnslgrgjemgk",GSTNoDate: "29309238033902",IFSCcode: "kmk",IncomeTaxPanNo: "8384705257029",Insurance: "no",Managementstaff: "9392",MobileNo: "3288702375",North: "",ProprietorAddress: "nsdln",Proprietoremail: "jnefkji",Proprietorowner: "nsja",Proprietorpan: "nsdjak",Proprietorphone: "84u50",ProprietorusineesName: "mnsdvns",RegisteredAddress1: "wz-127 tilak nagar",RegisteredAddress2: "",RegisteredAddress3: "",RegisteredBusinessName: "spice+mobile",accountnumber: "nk",bEntity: "Partnership",bPmpdetail: "Proprietor",bankname: "kmk",businessmodel: "Retailer",city: "delhi",contactemail1: "84300293-92",contactemail2: "",contactname1: "nas+c",contactname2: "",contactno1: "8435092",contactno2: "",descriptionofExistingbusiness: "jsdnkglelr",east: "34",front: "",loan: "yes",location: "shoppingMall",neareststore: "100mtrs",noofemployess: "823u9",ownership: "Rented",partnerAddress1: "",partnerAddress2: "",partnerAddress3: "",partnerAddress4: "",partnerName1: "",partnerName2: "",partnerName3: "",partnerName4: "",partneremail1: "",partneremail2: "",partneremail3: "",partneremail4: "",partnerowner1: "",partnerowner2: "",partnerowner3: "",partnerowner4: "",partnerpan1: "",partnerpan2: "",partnerpan3: "",partnerpan4: "",partnerphone1: "",partnerphone2: "",partnerphone3: "",partnerphone4: "",pincode: "110018",portalName1: "",portalName2: "",portalName3: "",roadsize: "",sellingonline: "no",shareholderAddress1: "",shareholderAddress2: "",shareholderAddress3: "",shareholderAddress4: "",shareholderName1: "",shareholderName2: "",shareholderName3: "",shareholderName4: "",shareholderemail1: "",shareholderemail2: "",shareholderemail3: "",shareholderemail4: "",shareholderowner1: "",shareholderowner2: "",shareholderowner3: "",shareholderowner4: "",shareholderpan1: "",shareholderpan2: "",shareholderpan3: "",shareholderpan4: "",shareholderphone1: "",shareholderphone2: "",shareholderphone3: "",shareholderphone4: "",shopArea: "on",shopAvailbility: "Groundfloor",shopWashroom: "Washroom",shopWater: "Watersupply",shopstatus: "fullfurnished",south: "49",state: "Haryana",storeAddress: "",storename: "",telno: "7597209570",west: "32"}*/
22095 kshitij.so 142
 
143
function jQFormSerializeArrToJson(formSerializeArr){
144
 var jsonObj = {};
145
 jQuery.map( formSerializeArr, function( n, i ) {
146
     jsonObj[n.name] = n.value;
147
 });
148
 return jsonObj;
149
}
150
 
151
</script>
152
 
153
<style>
154
.loading-image {
155
position: fixed;
156
top: 50%;
157
left: 50%;
158
margin-top: -50px;
159
margin-left: -100px;
160
z-index: 100;
161
}
162
</style>
163
 
164
</head>
165
 
166
<body>
167
<div class="container">
168
    <div class="row">
169
         <div class ="header">   
170
		 <h3 class="header">HOTSPOT PARTNER STORE</h3>
171
         <h4 class="header">Powered by Profit Mandi (A Unit of Spice Group)</h4>
172
         </div>
173
 
174
        <div class="header">
175
            <h5 class="header">APPLICATION FOR REGISTRATION</h5>
176
       </div>  
177
        <hr />
178
 
179
        <div class="row">
180
            <div class="col-sm-8">
181
 
182
                <form role="form" name="myform" id ="form"  enctype="multipart/form-data"  data-toggle="validator" novalidate>
183
             <h4 class="page-header">1. Registered Business Name of HSPS (in Block Letters)</h4>
184
                     <div class="form-group ">
185
 
186
                     <label for=""></label>
187
                     <input type="text" name="registeredBusinessName" style="text-transform:uppercase;" id="demo" class="bform" placeholder="Business Name"/>
188
                     </div>
189
 
190
 
191
             <h4 class="page-header">2. Registered Address (In Block Letters)</h4>
192
 
193
                    <div class="form-group float-label-control">
194
                        <label for="">Line 1</label>
195
                        <input type="text" name ="line1" class="form-control" placeholder="Line 1">
196
                    </div>
197
                     <div class="form-group float-label-control">
198
                        <label for="">Line 2</label>
199
                        <input type="text" name ="line2"class="form-control" placeholder="Line 2">
200
                    </div>
201
                     <div class="form-group float-label-control">
202
                        <label for="">Line 3</label>
203
                        <input type="text" name="line3" class="form-control" placeholder="Line 3">
204
                    </div>
205
                     <div class="form-group float-label-control">
206
                        <label for="">City</label>
207
                        <input type="text" name="city" class="form-control" placeholder="City">
208
                    </div>
209
                      <div class="form-group float-label-control">
210
                        <label for="">District</label>
211
                        <input type="text" name="district" class="form-control" placeholder="District">
212
                    </div>
213
                     <div class="form-group float-label-control">
214
                        <label for="">Pincode</label>
215
                        <input  type="text" name="pincode" maxlength="6" class="form-control" pattern="[0-9]{6}" title="Please enter correct Pin Code"placeholder="Pincode">
216
                      </div>  
217
 
218
                     <div class="form-group float-label-control">
219
 
220
                      <select class="form-control" name = "state" placeholder="State">
221
                       <option value=" ">State</option>
222
                     <option value="Andaman and Nicobar Islands">Andaman and Nicobar Islands</option>
223
                            <option value="Andhra Pradesh">Andhra Pradesh</option>
224
                            <option value="Arunachal Pradesh">Arunachal Pradesh</option>
225
                            <option value="Assam">Assam</option>
226
                            <option value="Bihar">Bihar</option>
227
                            <option value="Chandigarh">Chandigarh</option>
228
                            <option value="Chhattisgarh">Chhattisgarh</option>
229
                            <option value="Dadra and Nagar Haveli">Dadra and Nagar Haveli</option>
230
                            <option value="Daman and Diu">Daman and Diu</option>
231
                            <option value="Delhi">Delhi</option>
232
                            <option value="Goa">Goa</option>
233
                            <option value="Gujarat">Gujarat</option>
234
                            <option value="Haryana">Haryana</option>
235
                            <option value="Himachal Pradesh">Himachal Pradesh</option>
236
                            <option value="Jammu and Kashmir">Jammu and Kashmir</option>
237
                            <option value="Jharkhand">Jharkhand</option>
238
                            <option value="Karnataka">Karnataka</option>
239
                            <option value="Kerala">Kerala</option>
240
                            <option value="Lakshadweep">Lakshadweep</option>
241
                            <option value="Madhya Pradesh">Madhya Pradesh</option>
242
                            <option value="Maharashtra">Maharashtra</option>
243
                            <option value="Manipur">Manipur</option>
244
                            <option value="Meghalaya">Meghalaya</option>
245
                            <option value="Mizoram">Mizoram</option>
246
                            <option value="Nagaland">Nagaland</option>
247
                            <option value="Orissa">Orissa</option>
248
                            <option value="Pondicherry">Pondicherry</option>
249
                            <option value="Punjab">Punjab</option>
250
                            <option value="Rajasthan">Rajasthan</option>
251
                            <option value="Sikkim">Sikkim</option>
252
                            <option value="Tamil Nadu">Tamil Nadu</option>
253
                            <option value="Tripura">Tripura</option>
254
                            <option value="Telangana">Telangana</option>
255
                            <option value="Uttaranchal">Uttaranchal</option>
256
                            <option value="Uttar Pradesh">Uttar Pradesh</option>
257
                            <option value="West Bengal">West Bengal</option>
258
                                              </select>
259
                    </div>
260
 
261
 
262
                      <div class="form-group float-label-control">
263
                        <label for="">Email1</label>
22139 amit.gupta 264
                        <input type="email" class="form-control" name="registeredEmail1" placeholder="Email1" readonly value="${email}">
22095 kshitij.so 265
                      </div>  
266
                         <p>Example:- xyz<strong>.hsps@gmail.com</strong></p>
267
 
268
 
269
 
270
                        <div class="form-group float-label-control">
271
                        <label for="">Email2</label>
272
                        <input type="email" class="form-control" name="registeredEmail2" placeholder="Email2">
273
                      </div> 
274
 
275
 
276
                       <div class="form-group float-label-control">
277
                        <label for="">Mobile</label>
278
                        <input  type="text" class="form-control" name="mobile" maxlength = "10" pattern="[0-9]{10}" title="Please enter valid Phone number" placeholder="Mobile">
279
                      </div>  
280
 
281
                    <label>Landline</label>
282
                      <div class="form-group Pmpform">
283
                      <input type="text" name="stdcode" maxlength = "5" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="STDcode"/> 
284
 
285
 
286
                      <input type="text" name="telephone" maxlength = "10" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="Telephone"/>
287
                      </div>
288
 
289
 
290
 
291
             <h4 class="page-header">3. Type of Business Entity</h4>
292
 
293
                   <div class="funkyradio">
294
 
295
                    <div class="funkyradio-primary">
296
                        <input type="radio" name="bEntity" id="radio1" value="SaleProprietorship" required>
297
                        <label for="radio1">Proprietor</label>
298
                    </div>
299
                    <div class="funkyradio-primary">
300
                        <input type="radio" name="bEntity" id="radio2" value="Partnership" required>
301
                        <label for="radio2">Partnership</label>
302
                    </div>
303
                    <div class="funkyradio-primary">
304
                        <input type="radio" name="bEntity" id="radio3" value="PrivateLimitedCompany" required>
305
                        <label for="radio3">Private Limited company</label>
306
                    </div>
307
                    <div class="funkyradio-primary">
308
                        <input type="radio" name="bEntity" id="radio4" value="LimitedLiabilityPartnership" required>
309
                        <label for="radio4">Limited Liability Partnership</label>
310
                    </div>
311
                </div>
312
                  <div class ="Entity">
313
                    <div class="SaleProprietorship box" id ="saleSaleProprietorship">Upload <strong>Proprietership proof</strong></div>
314
                     <div class="partnership box" id="salePartnership">Upload <strong>Partnership Deed</strong></div>
315
                     </div>
316
                      <div class="limitedcompany box" id="salePrivateLimitedCompany">
317
                      <div class="form-group float-label-control">
318
                        <label for="">DIN Number</label>
319
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number">
320
                    </div>Upload <strong>Incorporation certificate,Memorandum & Article of association</strong>
321
                      </div>
322
 
323
 
324
                      <div class="LimitedLiabilityPartnership box" id="saleLimitedLiabilityPartnership">
325
 
326
 
327
                           <div class="form-group float-label-control">
328
                        <label for="">DIN Number</label>
329
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number">
330
                    </div>Upload <strong>Registration certificate & partnership Deed</strong>
331
                     </div>
332
 
333
                    <div class = "form-group file upload"> 
334
                   <input type="file" accept="application/pdf,image/*" id="doc" name ="doc_bEntityDoc">
335
 
336
                   <input type="hidden" name="bEntityDoc"/>
337
                    </div>
338
 
339
                     <h4 class="page-header">4. Goods And Services Tax Number(GST)</h4>
340
                    <div class="Pmpform">
341
 
342
                        <input type="text" name="gst" class="bform" placeholder="Goods And Services Tax Number"/>
343
                    </div>
344
                     <p>Provide Copy of GST document</p>
345
                    <div class = "file upload"> 
346
                   <input type="file"  accept="application/pdf,image/*" name ="doc_gstDoc">
347
                     <input type="hidden" name="gstDoc"/>
348
                    </div>
349
 
350
 
351
                     <h4 class="page-header">5. Permanent Account Number(PAN)</h4>
352
                    <div class="form-group ">
353
 
354
                     <label for=""></label>
355
                     <input type="text" name="pan" maxlength="10" class="bform" placeholder="Permanent Account Number"/></div>
356
                     <p>Provide Copy of PAN </p>
357
 
358
                    <div class = "form-group file upload"> 
359
 
360
                   <input type="file" accept="application/pdf,image/*" name="doc_panDoc">
361
                     <input type="hidden" name="panDoc"/>
362
                    </div>
363
 
364
 
365
             <h4 class="page-header">6. Full Details Of Business Entity</h4>
366
 
367
                   <div class="funkyradio">
368
                    <div class="funkyradio-primary">
369
                        <input type="radio" name="bPmpDetail" id="business1" value="Proprietor" required>
370
                        <label for="business1">Proprietor</label>
371
                    </div>
372
                    <div class="funkyradio-primary">
373
                        <input type="radio" name="bPmpDetail" id="business2" value="Partners" required>
374
                        <label for="business2">Partners</label>
375
                    </div>
376
                    <div class="funkyradio-primary">
377
                        <input type="radio" name="bPmpDetail" id="business3" value="Directors" required>
378
                        <label for="business3">Directors</label>
379
                    </div>
380
                </div>
381
 
382
                <div class="tablecontainer">
383
   <table class="businessdetail">
384
              <tr> 
385
              <th class ="PMPName">Name</th>
386
              <th  class="PMPAddress">Address</th> 
387
              <th class="PMPtelno">Mobile</th>
388
              <th class="PMPpan">PAN</th>
389
              <th class="PMPAdhaar">Aadhaar Number</th>
390
              <th class="PMPemail">Email</th>
391
              <th class="PMPownership">Share %</th>
392
 
393
               </tr>
394
            <tr>
395
 
396
                   <td class="form-group"><input type="text" name="proprietorBusineesName"size="25"></td>
397
                   <td class="form-group"><textarea row="3" name="proprietorAddress"></textarea></td>
398
                   <td class="form-group"><input type="text" name="proprietorPhone" maxlength="10" pattern="[0-9]{10}"size="10"></th>
399
                   <td class="form-group"><input type="text" name="proprietorPan" maxlength="10" title="Please enter correct pan number"size="10"></td>
400
                    <td class="form-group"><input type="text"  name= "proprietorAdhaar" size="15"></td>
401
                   <td class="form-group"><input type="email"  name= "proprietorEmail" size="20"></td>
402
                   <td class="form-group"><input type="text" pattern="[0-9]" name="proprietorOwner" size="10"></td>
403
 
404
                   </tr>
405
 
406
 
407
            </table>
408
 
409
            </div>
410
            <div class="Partners pmp" id= "PmpPartners">
411
            <table class="businessdetail">
412
 
413
             <tr> 
414
              <th class ="PMPName">Name</th>
415
              <th  class="PMPAddress">Address</th> 
416
              <th class="PMPtelno">Mobile</th>
417
              <th class="PMPpan">PAN</th>
418
              <th class="PMPAdhaar">Aadhaar Number</th>
419
              <th class="PMPemail">Email</th>
420
              <th class="PMPownership">Share %</th>
421
 
422
               </tr>
423
                <tr>
424
 
425
                   <td class="form-group"><input name="partnerName1"type="text" size="25"></td>
426
                   <td class="form-group"><textarea name="partnerAddress1" type="text" size="60"></textarea></td>
427
                   <td class="form-group"><input name = "partnerPhone1" pattern="[0-9]{10}"type="text" size="10"></th>
428
                   <td class="form-group"><input  name ="partnerPan1"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
429
                    <td class="form-group"><input name="partnerAdhaar1" type="text"  size="15"></td>
430
                   <td class="form-group"><input name="partnerEmail1" type="email"  size="20"></td>
431
                   <td class="form-group"><input name="partnerOwner1" type="text"pattern="[0-9]"size="10"></td>
432
 
433
                   </tr>
434
 
435
 
436
            </table>
437
 
438
                   <table class="businessdetail">
439
 
440
             <tr> 
441
              <th class ="PMPName">Name</th>
442
              <th  class="PMPAddress">Address</th> 
443
              <th class="PMPtelno">Mobile</th>
444
              <th class="PMPpan">PAN</th>
445
              <th class="PMPAdhaar">Aadhaar Number</th>
446
              <th class="PMPemail">Email</th>
447
              <th class="PMPownership">Share %</th>
448
 
449
               </tr>
450
              <tr>
451
 
452
                   <td class="form-group"><input name="partnerName2"type="text" size="25"></td>
453
                   <td class="form-group"><textarea name="partnerAddress2" type="text" size="60"></textarea></td>
454
                   <td class="form-group"><input name = "partnerPhone2" pattern="[0-9]{10}" type="text" size="10"></th>
455
                   <td class="businesspan"><input  name ="partnerPan2"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
456
                   <td class="form-group"><input name="partnerAdhaar2" type="text" size="15"></td>
457
                   <td class="form-group"><input name="partnerEmail2" type="email" size="20"></td>
458
                   <td class="form-group"><input name="partnerOwner2" pattern="[0-9]" type="text" size="10"></td>
459
 
460
                   </tr>
461
 
462
            </table>
463
                   <table class="businessdetail">
464
             <tr> 
465
            <th class ="PMPName">Name</th>
466
              <th  class="PMPAddress">Address</th> 
467
              <th class="PMPtelno">Mobile</th>
468
              <th class="PMPpan">PAN</th>
469
              <th class="PMPAdhaar">Aadhaar Number</th>
470
              <th class="PMPemail">Email</th>
471
              <th class="PMPownership">Share %</th>
472
 
473
               </tr>
474
                 <tr>
475
 
476
                   <td class="form-group"><input name="partnerName3"type="text" size="25"></td>
477
                   <td class="form-group"><textarea name="partnerAddress3" type="text" size="60"></textarea></td>
478
                   <td class="form-group"><input name = "partnerPhone3" type="text"  maxlength = "10" pattern="[0-9]{10}"  size="10"></th>
479
                   <td class="form-group"><input  name ="partnerPan3"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
480
                    <td class="form-groupr"><input name="partnerAdhaar3" type="text" size="15"></td>
481
                   <td class="form-group"><input name="partnerEmail3"  type="email" size="20"></td>
482
                   <td class="form-group"><input name="partnerOwner3" pattern="[0-9"  type="text" size="10"></td>
483
 
484
                   </tr>
485
 
486
 
487
            </table>
488
 
489
 
490
 
491
           <table class="businessdetail">
492
       <tr> 
493
                <th class ="PMPName">Name</th>
494
              <th  class="PMPAddress">Address</th> 
495
              <th class="PMPtelno">Mobile</th>
496
              <th class="PMPpan">PAN</th>
497
              <th class="PMPAdhaar">Aadhaar Number</th>
498
              <th class="PMPemail">Email</th>
499
              <th class="PMPownership">Share %</th>
500
               </tr>
501
               <tr>
502
 
503
                   <td class="form-group"><input name="partnerName4"type="text" size="25"></td>
504
                   <td class="form-group"><textarea name="partnerAddress4" type="text" size="60"></textarea></td>
505
                   <td class="form-group"><input name = "partnerPhone4"  pattern="[0-9]{10}" type="text" size="10"></th>
506
                   <td class="form-group"><input  name ="partnerPan4"type="text" maxlength = "10"title="Please enter correct pan number"size="10"></td>
507
                    <td class="form-group"><input name="partnerAdhaar4" type="text" size="15"></td>
508
                   <td class="form-group"><input name="partnerEmail4" type="email" size="20"></td>
509
                   <td class="form-group"><input name="partnerOwner4" pattern="[0-9]" type="text" size="10"></td>
510
 
511
                   </tr>
512
 
513
 
514
            </table>
515
 
516
            </div>
517
 
518
 
519
             <div class="Directors pmp" id= "PmpDirectors">
520
            <table class="businessdetail">
521
               <tr> 
522
               <th class ="PMPName">Name</th>
523
              <th  class="PMPAddress">Address</th> 
524
              <th class="PMPtelno">Mobile</th>
525
              <th class="PMPpan">PAN</th>
526
              <th class="PMPAdhaar">Aadhaar Number</th>
527
              <th class="PMPemail">Email</th>
528
              <th class="PMPownership">Share %</th>
529
 
530
               </tr>
531
               <tr>
532
                   <td class="form-group"><input name="shareholderName1"type="text" size="25"></td>
533
                   <td class="form-group"><textarea name="shareholderAddress1" type="text" size="60"></textarea></td>
534
                   <td class="form-group"><input name = "shareholderPhone1" pattern="[0-9]{10}" type="text" size="10"></th>
535
                   <td class="form-group"><input  name ="shareholderPan1"type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
536
                   <td class="form-group"><input name="shareholderAdhaar1" type="text" size="15"></td>
537
                   <td class="form-group"><input name="shareholderEmail1" type="email" size="20"></td>
538
                   <td class="form-group"><input name="shareholderOwner1" pattern="[0-9]" type="text" size="10"></td>
539
 
540
                   </tr>
541
 
542
 
543
            </table>
544
 
545
                   <table class="businessdetail">
546
          <tr> 
547
                <th class ="PMPName">Name</th>
548
              <th  class="PMPAddress">Address</th> 
549
              <th class="PMPtelno">Mobile</th>
550
              <th class="PMPpan">PAN</th>
551
              <th class="PMPAdhaar">Aadhaar Number</th>
552
              <th class="PMPemail">Email</th>
553
              <th class="PMPownership">Share %</th>
554
               </tr>
555
                 <tr>
556
                   <td class="form-group"><input name="shareholderName2"type="text" size="25"></td>
557
                   <td class="form-group"><textarea name="shareholderAddress2" type="text" size="60"></textarea></td>
558
                   <td class="form-group"><input name = "shareholderPhone2" pattern="[0-9]{10}" type="text" size="10"></th>
559
                   <td class="form-group"><input  name ="shareholderPan2"type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
560
                    <td class="form-group"><input name="shareholderAdhaar2" type="text" size="15"></td>
561
                   <td class="form-group"><input name="shareholderEmail2"  type="email" size="20"></td>
562
                   <td class="form-group"><input name="shareholderOwner2" pattern="[0-9]"  type="text" size="10"></td>
563
 
564
                   </tr>
565
            </table>
566
 
567
                   <table class="businessdetail">
568
              <tr> 
569
                <th class ="PMPName">Name</th>
570
              <th  class="PMPAddress">Address</th> 
571
              <th class="PMPtelno">Mobile</th>
572
              <th class="PMPpan">PAN</th>
573
              <th class="PMPAdhaar">Aadhaar Number</th>
574
              <th class="PMPemail">Email</th>
575
              <th class="PMPownership">Share %</th>
576
 
577
               </tr>
578
                   <tr>
579
                   <td class="form-group"><input name="shareholderName3"type="text" size="25"></td>
580
                   <td class="form-group"><textarea name="shareholderAddress3" type="text" size="60"></textarea></td>
581
                   <td class="form-group"><input name = "shareholderPhone3" pattern="[0-9]{10}" type="text" size="10"></th>
582
                   <td class="form-group"><input  name ="shareholderPan3" type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
583
                   <td class="form-group"><input name="shareholderAdhaar3" type="text" size="15"></td>
584
                   <td class="form-group"><input name="shareholderEmail3" type="email" size="20"></td>
585
                   <td class="form-group"><input name="shareholderOwner3" pattern="[0-9]" type="text" size="10"></td>
586
 
587
                   </tr>
588
 
589
            </table>
590
 
591
                   <table class="businessdetail">
592
             <tr> 
593
                <th class ="PMPName">Name</th>
594
              <th  class="PMPAddress">Address</th> 
595
              <th class="PMPtelno">Mobile</th>
596
              <th class="PMPpan">PAN</th>
597
              <th class="PMPAdhaar">Aadhaar Number</th>
598
              <th class="PMPemail">Email</th>
599
              <th class="PMPownership">Share %</th>
600
               </tr>
601
                     <tr>
602
                   <td class="form-group"><input name="shareholderName4" type="text" size="25"></td>
603
                   <td class="form-group"><textarea name="shareholderAddress4" type="text" size="60"></textarea></td>
604
                   <td class="form-group"><input name = "shareholderPhone4" type="text" pattern="[0-9]{10}" size="10"></th>
605
                   <td class="form-group"><input  name ="shareholderPan4" type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
606
                    <td class="form-group"><input name="shareholderAdhaar4" type="text" size="15"></td>
607
                   <td class="form-group"><input name="shareholderEmail4"  type="email" size="20"></td>
608
                   <td class="form-group"><input name="shareholderOwner4" pattern="[0-9]"  type="text" size="10"></td>
609
 
610
                   </tr>
611
 
612
 
613
            </table>
614
 
615
            </div>
616
 
617
         <h4 class="page-header">7. Store Manager Details</h4>
618
 
619
 
620
                    <div class="form-group">
621
                    <label for="">Name
622
                    <input type="text" name="managerName"placeholder="Name"></label>
623
                    <label for="">Mobile
624
                        <input type="text" name="managerNo" pattern="[0-9]{10}" title="Please enter Valid Mobile number" placeholder="Mobile No"> </label>  
625
                    <label for="">Email
626
                        <input type="email" name="managerEmail"size="25px" placeholder="Emailid"> </label>  
627
 
628
                    </div>
629
 
630
 
631
            <h4 class="page-header">8. Manpower Details</h4>
632
 
633
               <div class="form-group">
634
                    <label for="">Number of Employees
635
                    <input type="text" pattern="[0-9]" name="noOfEmployees"placeholder="Number of Employees"></label>
636
                    <label for="">Number of Management Staff
637
                        <input type="text" pattern="[0-9]" name="managementStaff" placeholder="Management Staff"> </label>  
638
 
639
                    </div>
640
 
641
              <h4 class="page-header">9. Experience In Telecom Trade/other Trade (Brand & Product Category)</h4>
642
                <div class="bcontacts">
643
                   <textarea rows="4" name="experienceinTelecome"cols="50" placeholder="Describe yourself here..."></textarea> 
644
                </div>
645
 
646
            <h4 class="page-header">10. Description of Existing Business & Annual Turnover</h4>
647
                <div class="bcontacts">
648
                      <textarea rows="4" name="descriptionofExistingBusiness"cols="50" placeholder="Describe yourself here..."></textarea>
649
                </div>
650
                <p>Please Provide ITR of last Two years</p>
651
                <div class = "form-group file upload"> 
652
                   <input type="file" accept="application/pdf,image/*" name ="doc_itrDoc">
653
                      <input type="hidden" name="itrDoc"/>
654
                    </div>
655
 
656
 
657
            <h4 class="page-header">11.Business Model</h4>
658
 
659
            <div class="btn-group">
660
                    <label class="btn btn-default">
661
                   <input type="radio" name="businessModel" value="Retailer" required>
662
                   <span>Retailer</span>
663
                  </label>
664
                <label class="btn btn-default">
665
                    <input type="radio" name="businessModel" value="Distributor" required>
666
                    <span>Distributor</span>
667
                </label>
668
                <label class="btn btn-default">
669
                    <input type="radio" name="businessModel" value="Franchises" required>
670
                    <span>Franchise</span>
671
                </label>
672
                  <label class="btn btn-default">
673
                    <input type="radio" name="businessModel" value="Other" required>
674
                    <span>Other</span>
675
                </label>
676
              </div>
677
 
678
 
679
          <h4 class="page-header">12. Selling Online (if yes, please specify Portal Names)</h4>
680
 
681
                    <div class="btn-group">
682
                    <label class="btn btn-default">
683
                   <input type="radio" name="sellingOnline" value="yes">
684
                   <span>Yes</span>
685
                  </label>
686
                <label class="btn btn-default">
687
                    <input type="radio" name="sellingOnline" value="no">
688
                    <span>No</span>
689
                </label>
690
              </div>
691
                   <div class="form-group portal Names" id = "sellingyes">
692
                   <label>Portal Names</label>
693
                       <input type="text" name="portalName1" size="25">
694
                       <input type="text" name="portalName2" size="25">
695
                       <input type="text" name="portalName3" size="25">
696
                  </div>
697
            <h4 class="page-header">13. Area of Shop(in Sq Feet)</h4>
698
              <div>
699
                 <div class="form-group">
700
                    <label>
701
 
702
                    <input type="number" name="east"  placeholder="East(Sq Feet)">
703
                    <input type="number" name="west"  placeholder="West(Sq Feet)">
704
                    <input type="number" name="north" placeholder="North(Sq Feet)"> 
705
                    </label>
706
                </div>
707
                    <br>
708
                      <div class="form-group">
709
                    <label>
710
 
711
                    <input type="number" name="south" placeholder="South(Sq Feet)">
712
                    <input type="number" name="front" placeholder="Front(Sq Feet)">
713
                    <input type="number" name="roadSize" placeholder="Road Size in Front(Sq Feet)">
714
 
715
                    </label>
716
                </div>
717
 
718
                  </div>  
719
                  <div class="shopArea">
720
                   <div class="btn-group">
721
                    <label class="btn btn-default">
722
                   <input type="radio" name="shopArea" value="Singleside">
723
                   <span>Single Side</span>
724
                  </label>
725
                <label class="btn btn-default">
726
                    <input type="radio" name="shopArea" value"Twoside">
727
                    <span>Two Side</span>
728
                </label>
729
                  <label class="btn btn-default">
730
                    <input type="radio" name="shopArea" value="Corner">
731
                    <span>Corner</span>
732
                </label>
733
              </div>
734
              </div>
735
 
736
 
737
              <h4 class="page-header">14. Status of Shop</h4>
738
 
739
                 <div class="btn-group">
740
                    <label class="btn btn-default">
741
                   <input type="radio" name="shopStatus" value="semifurnished">
742
                   <span>Semi Furnished</span>
743
                  </label>
744
                <label class="btn btn-default">
745
                    <input type="radio" name="shopStatus" value="fullfurnished">
746
                    <span>Fully Furnished</span>
747
                </label>
748
                </div>
749
 
750
                 <div class="checkboxes status" id ="shopsemifurnished">
751
                 <div class="btn btn-default">
752
   <label for="success1" class="btn btn-success">Flooring<input type="checkbox" name="flooring" 
753
          value ="flooring" id="success1" class="badgebox"><span class="badge">&check;</span></label>
754
        <label for="warning1" class="btn btn-success">Ceiling<input type="checkbox" name="cieling" value="ceiling" id="warning1" class="badgebox"><span class="badge">&check;</span></label>
755
 
756
 
757
              </div>
758
            </div>
759
 
760
<div class ="checkboxes status"  id ="shopfullfurnished">
761
          <div class="row text-center">
762
    <label for="default" class="btn btn-success">Store <input type="checkbox" name="store" value="yes" id="default" class="badgebox"><span class="badge">&check;</span></label>
763
        <label for="primary" class="btn btn-success">Washroom <input type="checkbox" name="washroom" value="yes" id="primary" class="badgebox"><span class="badge">&check;</span></label>
764
        <label for="info" class="btn btn-success">Water Supply<input type="checkbox" name="waterSupply" value="yes" id="info" class="badgebox"><span class="badge">&check;</span></label>
765
        <label for="success" class="btn btn-success">Electricity<input type="checkbox" name="electricity" 
766
          value ="yes" id="success" class="badgebox"><span class="badge">&check;</span></label>
767
        <label for="warning" class="btn btn-success">Pantry<input type="checkbox" name="pantry" value="yes" id="warning" class="badgebox"><span class="badge">&check;</span></label>
768
  </div>
769
    </div>
770
 
771
 
772
              <h4 class="page-header">15. Shop Available At</h4>
773
 
774
                     <div class="btn-group">
775
                    <label class="btn btn-default">
776
                   <input type="radio" name="shopAvailbility" value="Basement">
777
                   <span>Basement</span>
778
                  </label>
779
                <label class="btn btn-default">
780
                    <input type="radio" name="shopAvailbility" value="Groundfloor">
781
                    <span>Ground Floor</span>
782
                </label>
783
                  <label class="btn btn-default">
784
                    <input type="radio" name="shopAvailbility" value="firstfloor">
785
                    <span>First Floor</span>
786
                </label>
787
 
788
                  <label class="btn btn-default">
789
                    <input type="radio" name="shopAvailbility" value="secondfloor">
790
                    <span>Second Floor</span>
791
                </label>
792
 
793
                 <label class="btn btn-default">
794
                    <input type="radio" name="shopAvailbility" value="thirdfloor">
795
                    <span>Third Floor</span>
796
                </label>
797
                </div>
798
 
799
                <div class="form-group bdetail">
800
                   <p>Provide pictures of the shop from 3 different angles, ceiling and flooring</p>
801
                      <input type="file" name="doc_angleDoc1" accept="application/pdf,image/*" >
802
                      <input type="hidden" name="angleDoc1"/>
803
                      <input type="file" name="doc_angleDoc2" accept="application/pdf,image/*" >
804
                      <input type="hidden" name="angleDoc2"/>
805
                      <input type="file" name="doc_angleDoc3"  accept="application/pdf,image/*" >
806
                      <input type="hidden" name="angleDoc3"/>
807
                      <input type="file" name="doc_angleDoc4"  accept="application/pdf,image/*" >
808
                      <input type="hidden" name="angleDoc4"/>
809
                      <input type="file" name="doc_angleDoc5" accept="application/pdf,image/*">
810
                      <input type="hidden" name="angleDoc5"/>
811
                  </div>
812
 
813
         <h4 class="page-header">16. Location of Shop</h4>
814
                        <div class="btn-group">
815
                    <label class="btn btn-default">
816
                   <input type="radio" name="location" value="shoppingMall">
817
                   <span>Shopping Mall</span>
818
                  </label>
819
                <label class="btn btn-default">
820
                    <input type="radio" name="location" value="MainMobileMarket">
821
                    <span>Main Mobile Market</span>
822
                </label>
823
                  <label class="btn btn-default">
824
                    <input type="radio" name="location" value="LocalMarket">
825
                    <span>Local Market</span>
826
                </label>
827
 
828
                </div>
829
 
830
 
831
 
832
             <h4 class="page-header">17.Nearest Mobile Store</h4>
833
                           <div class="btn-group">
834
                    <label class="btn btn-default">
835
                   <input type="radio" name="nearestStore" value="100mtrs">
836
                   <span>100Mtrs</span>
837
                  </label>
838
                <label class="btn btn-default">
839
                    <input type="radio" name="nearestStore" value="200mtrs">
840
                    <span>200Mtrs</span>
841
                </label>
842
                  <label class="btn btn-default">
843
                    <input type="radio" name="nearestStore" value="500mtrs">
844
                    <span>500Mtrs</span>
845
                </label>
846
 
847
                </div>
848
 
849
                 <div class="form-group location">
850
                   <label>Name of the Shop</label>
851
                       <input type="text" size ="35" name="storeName">
852
                       <br>
853
                       <br>
854
                        <label>Address of the Shop</label>
855
                       <input type="text" size ="65" name="storeAddress">
856
                  </div>
857
 
858
 
859
 
860
            <h4 class="page-header">18. Ownership of Shop</h4>
861
 
862
                    <div class="btn-group">
863
                    <label class="btn btn-default">
864
                   <input type="radio" name="ownership" value="Selfowned">
865
                   <span>Self Owned</span>
866
                  </label>
867
                <label class="btn btn-default">
868
                    <input type="radio" name="ownership" value="Rented">
869
                    <span>Rented</span>
870
                </label>
871
                  <label class="btn btn-default">
872
                    <input type="radio" name="ownership" value="lease">
873
                    <span>Lease</span>
874
                </label>
875
                  </label>
876
                  <label class="btn btn-default">
877
                    <input type="radio" name="ownership" value="collaboration">
878
                    <span>Collaboration</span>
879
                </label>
880
 
881
                </div>
882
 
883
                 <div class="form-group bdetail">
884
                   <p>Provide relevant documents (Electricity bill/Rent Agreement/Lease Deed)to prove the status of ownership</p>
885
                     <input type="file" accept="application/pdf,image/*" name="doc_ownershipDoc">
886
                     <input type="hidden" name="ownershipDoc"/>
887
                   </div>
888
 
889
 
890
           <h4 class="page-header">19. Insurance of Shop (if yes, please provide the copy of the same)</h4>
891
 
892
 
893
                    <div class="btn-group">
894
                    <label class="btn btn-default">
895
                   <input type="radio" name="insurance" value="yes">
896
                   <span>Yes</span>
897
                  </label>
898
                <label class="btn btn-default">
899
                    <input type="radio" name="insurance" value="no">
900
                    <span>No</span>
901
                </label>
902
              </div>
903
 
904
                 <div class="form-group insurance doc"  id= "docyes">
905
                  <p>Please provide copy of insurance document</p>
906
                     <input type="file" accept="application/pdf,image/*" name="doc_insuranceDoc">
907
                      <input type="hidden" name="insuranceDoc"/>
908
                   </div>
909
 
910
 
911
         <h4 class="page-header">20. Loan on Shop (LAP/BL/CC/others)</h4>
912
 
913
                     <div class="btn-group">
914
                    <label class="btn btn-default">
915
                   <input type="radio" name="loan" value="yes">
916
                   <span>Yes</span>
917
                  </label>
918
                <label class="btn btn-default">
919
                    <input type="radio" name="loan" value="no">
920
                    <span>No</span>
921
                </label>
922
              </div>
923
 
924
                 <div class="form-group loan document" id ="documentyes">
925
                  <p>Please provide current statement Letter</p>
926
                     <input type="file" accept="application/pdf,image/*" name="doc_loanDoc">
927
                     <input type="hidden" name="loanDoc"/>
928
                      <p>Please provide current sanction Letter</p>
929
                     <input type="file" accept="application/pdf,image/*" name="doc_sanctionDoc">
930
                     <input type="hidden" name="sanctionDoc"/>
931
                   </div>
932
 
933
 
934
            <h4 class="page-header">21. Bank Name & Address</h4>
935
 
936
                  <div class="form-group float-label-control">
937
                        <label for="">Account Number</label>
938
                        <input type="text" name="accountNumber"class="form-control" placeholder="Account Number">
939
                    </div>
940
                     <div class="form-group float-label-control">
941
                        <label for="">Bank Name</label>
942
                        <input type="text" name="bankName"class="form-control" placeholder="Bank Name">
943
                    </div>
944
                     <div class="form-group float-label-control">
945
                        <label for="">IFSC Code</label>
946
                        <input type="text" name="ifscCode"class="form-control" placeholder="IFSC Code">
947
                    </div>
948
                     <div class="form-group float-label-control">
949
                        <label for="">Branch Name</label>
950
                        <input type="text" name="branchName" class="form-control" placeholder="Branch Name">
951
                    </div>
952
                     <div >
953
                  <p>Please attach the copy of cancelled cheque</p>
954
                      <div class="form-group">
955
                     <input type="file" name="doc_chequeCopy" accept="application/pdf,image/*">
956
                     <input type="hidden" name="chequeCopy"/>
957
                   </div>
958
 
959
 
960
                  <h4 class="page-header">22. HSPS Bank Account Detail</h4> 
961
 
962
                  <p>Please deposit amount of <strong> Rs 1 Lac </strong>as advance payment in following account through NEFT and submit the UTR No.</p>
963
                    <div class="form-group float-label-control">
964
                        <label for="">UTR Number</label>
965
                        <input type="text" name="utr" class="form-control" placeholder="UTR No">
966
                    </div>
967
                    <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>
968
 
969
 
970
 
971
                      <div class ="Account">
972
                      <label>Account Name: New Spice Solutions Pvt Ltd</label><br>
973
                       <label>Bank Name: IndusInd Bank Ltd.</label><br>
974
                        <label>Account No.:201000488351</label><br>
975
                        <label>Branch:M-56, Greater Kailash-II, Main Market New Delhi-110048</label><br>
976
                         <label>IFSC:INDB0000012</label><br>
977
                        </div>
978
 
979
                <div class="submit">
980
                    <button type="submit" class="btn btn-success btn-lg">Submit</button>
981
                </div>
982
 
983
                <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>
984
 
985
 
986
 
987
 
988
 <!--             <fieldset hidden disabled="disabled">
989
              <h4 class="page-header">PMP STORE REGISTRATION APPROVAL</h4>
990
                 <p>(FOR OFFICE USE ONLY)</P>
991
 
992
                <div class=breg>
993
                 <div class=bApproval>
994
 
995
                  <label>Recommended by</label>
996
                  <input type="text" name = "recommended"class="reg-control" size="50">
997
 
998
                  </div>
999
                  <br>
1000
 
1001
                    <div class=bApproval>
1002
                  <label>Business Manager</label>
1003
                  <input type="text" name=" bManager" class="reg-control" size="50">
1004
                </div>
1005
                      <br>
1006
                        <div class=bApproval>
1007
                    <label>Operations Manager</label>
1008
                  <input type="text"name="operation"class="reg-control"  size="50">
1009
                </div>
1010
                  <br>
1011
               <div class=bApproval>
1012
                     <label>BusinessHeadCategoryHead</label>
1013
                  <input type="text" name="bhead"class="reg-control" size="50">
1014
                </div>
1015
 
1016
 
1017
                 </div>
1018
               </fieldset> -->
1019
 
1020
                      </form>
1021
                    </div>
1022
          </div>
1023
   <div class="col-sm-4">
1024
                <div class="panel panel-default">
1025
 
1026
                    <div class="panel-body">
1027
 
1028
 
1029
                   <label>Spice Global Knowledge Park - 6th Floor, Plot No.19A & 19B, Sector 125, Noida, UP - 201301</label>
1030
                   <br>
1031
                    <label>Email - care@profitmandi.com</<label>
1032
                    <br> 
1033
                    <label>Contact - 8588842949 </label>
1034
                    </div>
1035
                </div>
1036
            </div>
1037
 
1038
        </div>
1039
 
1040
    </div>
1041
    </div>
1042
</body>
1043
</html>