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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">
22155 amit.gupta 17
contexPath = "${rc.contextPath}";
22095 kshitij.so 18
 $(document).ready(function(){
19
 
20
    $("input[name$='bEntity']").click(function() {
21
        var test1 = $(this).val();
22
       $(".box").hide();
23
       $('input[name=dinNumber]').each(function(){
24
         $(this).prop('disabled', true);
25
      });
26
 
27
       var dinNumberInput = $("#sale"+test1+ " input[name=dinNumber]");
28
       if (dinNumberInput.prop('disabled') == true){
29
            dinNumberInput.prop('disabled', false);
30
       } 
31
        $("#sale" + test1).show();
32
});
33
});
34
</script>
35
 
36
<script type="text/javascript">
37
$(document).ready(function(){
38
    $("input[name$='bPmpDetail']").click(function() {
39
        var test1 = $(this).val();
40
       $(".pmp").hide();
41
        $("#Pmp" + test1).show();
42
    });
43
});
44
 
45
</script>
46
 
47
<script type="text/javascript">
48
$(document).ready(function(){
49
    $("input[name$='shopStatus']").click(function() {
50
        var test1 = $(this).val();
51
          $("#shopsemifurnished, #shopfullfurnished").find("input[type=checkbox]").each(function(){
52
         $(this).prop('disabled', true);
53
    });
54
 
55
       $(".status").hide();
56
       $("#shop" + test1).show();
57
       $("#shop" + test1).find("input[type=checkbox]").prop('disabled', false);
58
 
59
 
60
 
61
 
62
    });
63
});
64
 
65
</script>
66
<script type="text/javascript">
67
$(document).ready(function(){
68
    $("input[name$='sellingOnline']").click(function() {
69
        var test1 = $(this).val();
70
       $(".Names").hide();
71
        $("#selling" + test1).show();
72
    });
73
});
74
 
75
</script>
76
 
77
 
78
<script type="text/javascript">
79
$(document).ready(function(){
80
    associateValidator();
81
    $("input[name$='insurance']").click(function() {
82
        var test1 = $(this).val();
83
       $(".doc").hide();
84
        $("#doc" + test1).show();
85
    });
86
});
87
 
88
</script>
89
 
90
<script type="text/javascript">
22155 amit.gupta 91
docsArray = ['doc_bEntityDoc','doc_gstDoc','doc_panDoc','doc_itrDoc','doc_angleDoc1','doc_angleDoc2','doc_angleDoc3','doc_angleDoc4','doc_angleDoc5','doc_ownershipDoc','doc_insuranceDoc','doc_loanDoc','doc_sanctionDoc','doc_chequeCopy'];
22095 kshitij.so 92
$(document).ready(function(){
93
    $("input[name$='loan']").click(function() {
94
        var test1 = $(this).val();
95
       $(".document").hide();
96
        $("#document" + test1).show();
97
        $("#showHide").show();
98
    });
99
 
100
  docsArray.forEach(function(inputName){
101
 
102
	   $('input[name="' + inputName + '"]').change(function(e){
103
	    var formData = new FormData();
104
	    that = this;
105
		formData.append("file", $(this)[0].files[0]);
106
		jQuery.ajax({
22186 amit.gupta 107
	          url: window.location.hostname + ":8080/profitmandi-web/document-upload",
22095 kshitij.so 108
	          type: 'POST',
109
	          data: formData,
110
	          	cache: false,
111
            contentType: false,
112
            processData: false,
113
	            processData: false,
114
	           success: function (data) {
115
	           console.log(data);
116
	           	hiddenInput = inputName.split("_")[1];
117
	           	var doc_id = 0;
118
	           	if (data.response.document_id == 0){
119
	           		alert(data.response.message);
120
	           		return;
121
	           	}
122
	               $('input[name="' + hiddenInput + '"]').val(data.response.document_id);
22152 amit.gupta 123
	               validator.data('bootstrapValidator').revalidateField($('input[name="' + hiddenInput + '"]'));
22095 kshitij.so 124
	           }
125
	    });
126
	});
127
 
128
  });
129
});
130
 
131
function queryStringToJSON(queryString) {
132
  var pairs = queryString.split('&');
133
  var result = {};
134
  pairs.forEach(function(pair) {
135
    pair = pair.split('=');
136
    result[pair[0]] = decodeURIComponent(pair[1] || '');
137
 
138
  });
139
  return result;
140
}
141
 
22148 amit.gupta 142
/*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 143
 
144
function jQFormSerializeArrToJson(formSerializeArr){
145
 var jsonObj = {};
146
 jQuery.map( formSerializeArr, function( n, i ) {
147
     jsonObj[n.name] = n.value;
148
 });
149
 return jsonObj;
150
}
151
 
152
</script>
153
 
154
<style>
155
.loading-image {
156
position: fixed;
157
top: 50%;
158
left: 50%;
159
margin-top: -50px;
160
margin-left: -100px;
161
z-index: 100;
162
}
163
</style>
164
 
165
</head>
166
 
167
<body>
168
<div class="container">
169
    <div class="row">
170
         <div class ="header">   
171
		 <h3 class="header">HOTSPOT PARTNER STORE</h3>
172
         <h4 class="header">Powered by Profit Mandi (A Unit of Spice Group)</h4>
173
         </div>
174
 
175
        <div class="header">
176
            <h5 class="header">APPLICATION FOR REGISTRATION</h5>
177
       </div>  
178
        <hr />
179
 
180
        <div class="row">
181
            <div class="col-sm-8">
182
 
183
                <form role="form" name="myform" id ="form"  enctype="multipart/form-data"  data-toggle="validator" novalidate>
184
             <h4 class="page-header">1. Registered Business Name of HSPS (in Block Letters)</h4>
185
                     <div class="form-group ">
186
 
187
                     <label for=""></label>
188
                     <input type="text" name="registeredBusinessName" style="text-transform:uppercase;" id="demo" class="bform" placeholder="Business Name"/>
189
                     </div>
190
 
191
 
192
             <h4 class="page-header">2. Registered Address (In Block Letters)</h4>
193
 
194
                    <div class="form-group float-label-control">
195
                        <label for="">Line 1</label>
196
                        <input type="text" name ="line1" class="form-control" placeholder="Line 1">
197
                    </div>
198
                     <div class="form-group float-label-control">
199
                        <label for="">Line 2</label>
200
                        <input type="text" name ="line2"class="form-control" placeholder="Line 2">
201
                    </div>
202
                     <div class="form-group float-label-control">
203
                        <label for="">Line 3</label>
204
                        <input type="text" name="line3" class="form-control" placeholder="Line 3">
205
                    </div>
206
                     <div class="form-group float-label-control">
207
                        <label for="">City</label>
208
                        <input type="text" name="city" class="form-control" placeholder="City">
209
                    </div>
210
                      <div class="form-group float-label-control">
211
                        <label for="">District</label>
212
                        <input type="text" name="district" class="form-control" placeholder="District">
213
                    </div>
214
                     <div class="form-group float-label-control">
215
                        <label for="">Pincode</label>
216
                        <input  type="text" name="pincode" maxlength="6" class="form-control" pattern="[0-9]{6}" title="Please enter correct Pin Code"placeholder="Pincode">
217
                      </div>  
218
 
219
                     <div class="form-group float-label-control">
220
 
221
                      <select class="form-control" name = "state" placeholder="State">
222
                       <option value=" ">State</option>
223
                     <option value="Andaman and Nicobar Islands">Andaman and Nicobar Islands</option>
224
                            <option value="Andhra Pradesh">Andhra Pradesh</option>
225
                            <option value="Arunachal Pradesh">Arunachal Pradesh</option>
226
                            <option value="Assam">Assam</option>
227
                            <option value="Bihar">Bihar</option>
228
                            <option value="Chandigarh">Chandigarh</option>
229
                            <option value="Chhattisgarh">Chhattisgarh</option>
230
                            <option value="Dadra and Nagar Haveli">Dadra and Nagar Haveli</option>
231
                            <option value="Daman and Diu">Daman and Diu</option>
232
                            <option value="Delhi">Delhi</option>
233
                            <option value="Goa">Goa</option>
234
                            <option value="Gujarat">Gujarat</option>
235
                            <option value="Haryana">Haryana</option>
236
                            <option value="Himachal Pradesh">Himachal Pradesh</option>
237
                            <option value="Jammu and Kashmir">Jammu and Kashmir</option>
238
                            <option value="Jharkhand">Jharkhand</option>
239
                            <option value="Karnataka">Karnataka</option>
240
                            <option value="Kerala">Kerala</option>
241
                            <option value="Lakshadweep">Lakshadweep</option>
242
                            <option value="Madhya Pradesh">Madhya Pradesh</option>
243
                            <option value="Maharashtra">Maharashtra</option>
244
                            <option value="Manipur">Manipur</option>
245
                            <option value="Meghalaya">Meghalaya</option>
246
                            <option value="Mizoram">Mizoram</option>
247
                            <option value="Nagaland">Nagaland</option>
248
                            <option value="Orissa">Orissa</option>
249
                            <option value="Pondicherry">Pondicherry</option>
250
                            <option value="Punjab">Punjab</option>
251
                            <option value="Rajasthan">Rajasthan</option>
252
                            <option value="Sikkim">Sikkim</option>
253
                            <option value="Tamil Nadu">Tamil Nadu</option>
254
                            <option value="Tripura">Tripura</option>
255
                            <option value="Telangana">Telangana</option>
256
                            <option value="Uttaranchal">Uttaranchal</option>
257
                            <option value="Uttar Pradesh">Uttar Pradesh</option>
258
                            <option value="West Bengal">West Bengal</option>
259
                                              </select>
260
                    </div>
261
 
262
 
263
                      <div class="form-group float-label-control">
264
                        <label for="">Email1</label>
22139 amit.gupta 265
                        <input type="email" class="form-control" name="registeredEmail1" placeholder="Email1" readonly value="${email}">
22095 kshitij.so 266
                      </div>  
267
                         <p>Example:- xyz<strong>.hsps@gmail.com</strong></p>
268
 
269
 
270
 
271
                        <div class="form-group float-label-control">
272
                        <label for="">Email2</label>
273
                        <input type="email" class="form-control" name="registeredEmail2" placeholder="Email2">
274
                      </div> 
275
 
276
 
277
                       <div class="form-group float-label-control">
278
                        <label for="">Mobile</label>
279
                        <input  type="text" class="form-control" name="mobile" maxlength = "10" pattern="[0-9]{10}" title="Please enter valid Phone number" placeholder="Mobile">
280
                      </div>  
281
 
282
                    <label>Landline</label>
283
                      <div class="form-group Pmpform">
284
                      <input type="text" name="stdcode" maxlength = "5" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="STDcode"/> 
285
 
286
 
287
                      <input type="text" name="telephone" maxlength = "10" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="Telephone"/>
288
                      </div>
289
 
290
 
291
 
292
             <h4 class="page-header">3. Type of Business Entity</h4>
293
 
294
                   <div class="funkyradio">
295
 
296
                    <div class="funkyradio-primary">
297
                        <input type="radio" name="bEntity" id="radio1" value="SaleProprietorship" required>
298
                        <label for="radio1">Proprietor</label>
299
                    </div>
300
                    <div class="funkyradio-primary">
301
                        <input type="radio" name="bEntity" id="radio2" value="Partnership" required>
302
                        <label for="radio2">Partnership</label>
303
                    </div>
304
                    <div class="funkyradio-primary">
305
                        <input type="radio" name="bEntity" id="radio3" value="PrivateLimitedCompany" required>
306
                        <label for="radio3">Private Limited company</label>
307
                    </div>
308
                    <div class="funkyradio-primary">
309
                        <input type="radio" name="bEntity" id="radio4" value="LimitedLiabilityPartnership" required>
310
                        <label for="radio4">Limited Liability Partnership</label>
311
                    </div>
312
                </div>
313
                  <div class ="Entity">
314
                    <div class="SaleProprietorship box" id ="saleSaleProprietorship">Upload <strong>Proprietership proof</strong></div>
315
                     <div class="partnership box" id="salePartnership">Upload <strong>Partnership Deed</strong></div>
316
                     </div>
317
                      <div class="limitedcompany box" id="salePrivateLimitedCompany">
318
                      <div class="form-group float-label-control">
319
                        <label for="">DIN Number</label>
320
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number">
321
                    </div>Upload <strong>Incorporation certificate,Memorandum & Article of association</strong>
322
                      </div>
323
 
324
 
325
                      <div class="LimitedLiabilityPartnership box" id="saleLimitedLiabilityPartnership">
326
 
327
 
328
                           <div class="form-group float-label-control">
329
                        <label for="">DIN Number</label>
330
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number">
331
                    </div>Upload <strong>Registration certificate & partnership Deed</strong>
332
                     </div>
333
 
334
                    <div class = "form-group file upload"> 
335
                   <input type="file" accept="application/pdf,image/*" id="doc" name ="doc_bEntityDoc">
336
 
337
                   <input type="hidden" name="bEntityDoc"/>
338
                    </div>
339
 
340
                     <h4 class="page-header">4. Goods And Services Tax Number(GST)</h4>
341
                    <div class="Pmpform">
342
 
343
                        <input type="text" name="gst" class="bform" placeholder="Goods And Services Tax Number"/>
344
                    </div>
345
                     <p>Provide Copy of GST document</p>
346
                    <div class = "file upload"> 
347
                   <input type="file"  accept="application/pdf,image/*" name ="doc_gstDoc">
348
                     <input type="hidden" name="gstDoc"/>
349
                    </div>
350
 
351
 
352
                     <h4 class="page-header">5. Permanent Account Number(PAN)</h4>
353
                    <div class="form-group ">
354
 
355
                     <label for=""></label>
356
                     <input type="text" name="pan" maxlength="10" class="bform" placeholder="Permanent Account Number"/></div>
357
                     <p>Provide Copy of PAN </p>
358
 
359
                    <div class = "form-group file upload"> 
360
 
361
                   <input type="file" accept="application/pdf,image/*" name="doc_panDoc">
362
                     <input type="hidden" name="panDoc"/>
363
                    </div>
364
 
365
 
366
             <h4 class="page-header">6. Full Details Of Business Entity</h4>
367
 
368
                   <div class="funkyradio">
369
                    <div class="funkyradio-primary">
370
                        <input type="radio" name="bPmpDetail" id="business1" value="Proprietor" required>
371
                        <label for="business1">Proprietor</label>
372
                    </div>
373
                    <div class="funkyradio-primary">
374
                        <input type="radio" name="bPmpDetail" id="business2" value="Partners" required>
375
                        <label for="business2">Partners</label>
376
                    </div>
377
                    <div class="funkyradio-primary">
378
                        <input type="radio" name="bPmpDetail" id="business3" value="Directors" required>
379
                        <label for="business3">Directors</label>
380
                    </div>
381
                </div>
382
 
383
                <div class="tablecontainer">
384
   <table class="businessdetail">
385
              <tr> 
386
              <th class ="PMPName">Name</th>
387
              <th  class="PMPAddress">Address</th> 
388
              <th class="PMPtelno">Mobile</th>
389
              <th class="PMPpan">PAN</th>
390
              <th class="PMPAdhaar">Aadhaar Number</th>
391
              <th class="PMPemail">Email</th>
392
              <th class="PMPownership">Share %</th>
393
 
394
               </tr>
395
            <tr>
396
 
397
                   <td class="form-group"><input type="text" name="proprietorBusineesName"size="25"></td>
398
                   <td class="form-group"><textarea row="3" name="proprietorAddress"></textarea></td>
399
                   <td class="form-group"><input type="text" name="proprietorPhone" maxlength="10" pattern="[0-9]{10}"size="10"></th>
400
                   <td class="form-group"><input type="text" name="proprietorPan" maxlength="10" title="Please enter correct pan number"size="10"></td>
401
                    <td class="form-group"><input type="text"  name= "proprietorAdhaar" size="15"></td>
402
                   <td class="form-group"><input type="email"  name= "proprietorEmail" size="20"></td>
403
                   <td class="form-group"><input type="text" pattern="[0-9]" name="proprietorOwner" size="10"></td>
404
 
405
                   </tr>
406
 
407
 
408
            </table>
409
 
410
            </div>
411
            <div class="Partners pmp" id= "PmpPartners">
412
            <table class="businessdetail">
413
 
414
             <tr> 
415
              <th class ="PMPName">Name</th>
416
              <th  class="PMPAddress">Address</th> 
417
              <th class="PMPtelno">Mobile</th>
418
              <th class="PMPpan">PAN</th>
419
              <th class="PMPAdhaar">Aadhaar Number</th>
420
              <th class="PMPemail">Email</th>
421
              <th class="PMPownership">Share %</th>
422
 
423
               </tr>
424
                <tr>
425
 
426
                   <td class="form-group"><input name="partnerName1"type="text" size="25"></td>
427
                   <td class="form-group"><textarea name="partnerAddress1" type="text" size="60"></textarea></td>
428
                   <td class="form-group"><input name = "partnerPhone1" pattern="[0-9]{10}"type="text" size="10"></th>
429
                   <td class="form-group"><input  name ="partnerPan1"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
430
                    <td class="form-group"><input name="partnerAdhaar1" type="text"  size="15"></td>
431
                   <td class="form-group"><input name="partnerEmail1" type="email"  size="20"></td>
432
                   <td class="form-group"><input name="partnerOwner1" type="text"pattern="[0-9]"size="10"></td>
433
 
434
                   </tr>
435
 
436
 
437
            </table>
438
 
439
                   <table class="businessdetail">
440
 
441
             <tr> 
442
              <th class ="PMPName">Name</th>
443
              <th  class="PMPAddress">Address</th> 
444
              <th class="PMPtelno">Mobile</th>
445
              <th class="PMPpan">PAN</th>
446
              <th class="PMPAdhaar">Aadhaar Number</th>
447
              <th class="PMPemail">Email</th>
448
              <th class="PMPownership">Share %</th>
449
 
450
               </tr>
451
              <tr>
452
 
453
                   <td class="form-group"><input name="partnerName2"type="text" size="25"></td>
454
                   <td class="form-group"><textarea name="partnerAddress2" type="text" size="60"></textarea></td>
455
                   <td class="form-group"><input name = "partnerPhone2" pattern="[0-9]{10}" type="text" size="10"></th>
456
                   <td class="businesspan"><input  name ="partnerPan2"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
457
                   <td class="form-group"><input name="partnerAdhaar2" type="text" size="15"></td>
458
                   <td class="form-group"><input name="partnerEmail2" type="email" size="20"></td>
459
                   <td class="form-group"><input name="partnerOwner2" pattern="[0-9]" type="text" size="10"></td>
460
 
461
                   </tr>
462
 
463
            </table>
464
                   <table class="businessdetail">
465
             <tr> 
466
            <th class ="PMPName">Name</th>
467
              <th  class="PMPAddress">Address</th> 
468
              <th class="PMPtelno">Mobile</th>
469
              <th class="PMPpan">PAN</th>
470
              <th class="PMPAdhaar">Aadhaar Number</th>
471
              <th class="PMPemail">Email</th>
472
              <th class="PMPownership">Share %</th>
473
 
474
               </tr>
475
                 <tr>
476
 
477
                   <td class="form-group"><input name="partnerName3"type="text" size="25"></td>
478
                   <td class="form-group"><textarea name="partnerAddress3" type="text" size="60"></textarea></td>
479
                   <td class="form-group"><input name = "partnerPhone3" type="text"  maxlength = "10" pattern="[0-9]{10}"  size="10"></th>
480
                   <td class="form-group"><input  name ="partnerPan3"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
481
                    <td class="form-groupr"><input name="partnerAdhaar3" type="text" size="15"></td>
482
                   <td class="form-group"><input name="partnerEmail3"  type="email" size="20"></td>
483
                   <td class="form-group"><input name="partnerOwner3" pattern="[0-9"  type="text" size="10"></td>
484
 
485
                   </tr>
486
 
487
 
488
            </table>
489
 
490
 
491
 
492
           <table class="businessdetail">
493
       <tr> 
494
                <th class ="PMPName">Name</th>
495
              <th  class="PMPAddress">Address</th> 
496
              <th class="PMPtelno">Mobile</th>
497
              <th class="PMPpan">PAN</th>
498
              <th class="PMPAdhaar">Aadhaar Number</th>
499
              <th class="PMPemail">Email</th>
500
              <th class="PMPownership">Share %</th>
501
               </tr>
502
               <tr>
503
 
504
                   <td class="form-group"><input name="partnerName4"type="text" size="25"></td>
505
                   <td class="form-group"><textarea name="partnerAddress4" type="text" size="60"></textarea></td>
506
                   <td class="form-group"><input name = "partnerPhone4"  pattern="[0-9]{10}" type="text" size="10"></th>
507
                   <td class="form-group"><input  name ="partnerPan4"type="text" maxlength = "10"title="Please enter correct pan number"size="10"></td>
508
                    <td class="form-group"><input name="partnerAdhaar4" type="text" size="15"></td>
509
                   <td class="form-group"><input name="partnerEmail4" type="email" size="20"></td>
510
                   <td class="form-group"><input name="partnerOwner4" pattern="[0-9]" type="text" size="10"></td>
511
 
512
                   </tr>
513
 
514
 
515
            </table>
516
 
517
            </div>
518
 
519
 
520
             <div class="Directors pmp" id= "PmpDirectors">
521
            <table class="businessdetail">
522
               <tr> 
523
               <th class ="PMPName">Name</th>
524
              <th  class="PMPAddress">Address</th> 
525
              <th class="PMPtelno">Mobile</th>
526
              <th class="PMPpan">PAN</th>
527
              <th class="PMPAdhaar">Aadhaar Number</th>
528
              <th class="PMPemail">Email</th>
529
              <th class="PMPownership">Share %</th>
530
 
531
               </tr>
532
               <tr>
533
                   <td class="form-group"><input name="shareholderName1"type="text" size="25"></td>
534
                   <td class="form-group"><textarea name="shareholderAddress1" type="text" size="60"></textarea></td>
535
                   <td class="form-group"><input name = "shareholderPhone1" pattern="[0-9]{10}" type="text" size="10"></th>
536
                   <td class="form-group"><input  name ="shareholderPan1"type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
537
                   <td class="form-group"><input name="shareholderAdhaar1" type="text" size="15"></td>
538
                   <td class="form-group"><input name="shareholderEmail1" type="email" size="20"></td>
539
                   <td class="form-group"><input name="shareholderOwner1" pattern="[0-9]" type="text" size="10"></td>
540
 
541
                   </tr>
542
 
543
 
544
            </table>
545
 
546
                   <table class="businessdetail">
547
          <tr> 
548
                <th class ="PMPName">Name</th>
549
              <th  class="PMPAddress">Address</th> 
550
              <th class="PMPtelno">Mobile</th>
551
              <th class="PMPpan">PAN</th>
552
              <th class="PMPAdhaar">Aadhaar Number</th>
553
              <th class="PMPemail">Email</th>
554
              <th class="PMPownership">Share %</th>
555
               </tr>
556
                 <tr>
557
                   <td class="form-group"><input name="shareholderName2"type="text" size="25"></td>
558
                   <td class="form-group"><textarea name="shareholderAddress2" type="text" size="60"></textarea></td>
559
                   <td class="form-group"><input name = "shareholderPhone2" pattern="[0-9]{10}" type="text" size="10"></th>
560
                   <td class="form-group"><input  name ="shareholderPan2"type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
561
                    <td class="form-group"><input name="shareholderAdhaar2" type="text" size="15"></td>
562
                   <td class="form-group"><input name="shareholderEmail2"  type="email" size="20"></td>
563
                   <td class="form-group"><input name="shareholderOwner2" pattern="[0-9]"  type="text" size="10"></td>
564
 
565
                   </tr>
566
            </table>
567
 
568
                   <table class="businessdetail">
569
              <tr> 
570
                <th class ="PMPName">Name</th>
571
              <th  class="PMPAddress">Address</th> 
572
              <th class="PMPtelno">Mobile</th>
573
              <th class="PMPpan">PAN</th>
574
              <th class="PMPAdhaar">Aadhaar Number</th>
575
              <th class="PMPemail">Email</th>
576
              <th class="PMPownership">Share %</th>
577
 
578
               </tr>
579
                   <tr>
580
                   <td class="form-group"><input name="shareholderName3"type="text" size="25"></td>
581
                   <td class="form-group"><textarea name="shareholderAddress3" type="text" size="60"></textarea></td>
582
                   <td class="form-group"><input name = "shareholderPhone3" pattern="[0-9]{10}" type="text" size="10"></th>
583
                   <td class="form-group"><input  name ="shareholderPan3" type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
584
                   <td class="form-group"><input name="shareholderAdhaar3" type="text" size="15"></td>
585
                   <td class="form-group"><input name="shareholderEmail3" type="email" size="20"></td>
586
                   <td class="form-group"><input name="shareholderOwner3" pattern="[0-9]" type="text" size="10"></td>
587
 
588
                   </tr>
589
 
590
            </table>
591
 
592
                   <table class="businessdetail">
593
             <tr> 
594
                <th class ="PMPName">Name</th>
595
              <th  class="PMPAddress">Address</th> 
596
              <th class="PMPtelno">Mobile</th>
597
              <th class="PMPpan">PAN</th>
598
              <th class="PMPAdhaar">Aadhaar Number</th>
599
              <th class="PMPemail">Email</th>
600
              <th class="PMPownership">Share %</th>
601
               </tr>
602
                     <tr>
603
                   <td class="form-group"><input name="shareholderName4" type="text" size="25"></td>
604
                   <td class="form-group"><textarea name="shareholderAddress4" type="text" size="60"></textarea></td>
605
                   <td class="form-group"><input name = "shareholderPhone4" type="text" pattern="[0-9]{10}" size="10"></th>
606
                   <td class="form-group"><input  name ="shareholderPan4" type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
607
                    <td class="form-group"><input name="shareholderAdhaar4" type="text" size="15"></td>
608
                   <td class="form-group"><input name="shareholderEmail4"  type="email" size="20"></td>
609
                   <td class="form-group"><input name="shareholderOwner4" pattern="[0-9]"  type="text" size="10"></td>
610
 
611
                   </tr>
612
 
613
 
614
            </table>
615
 
616
            </div>
617
 
618
         <h4 class="page-header">7. Store Manager Details</h4>
619
 
620
 
621
                    <div class="form-group">
622
                    <label for="">Name
623
                    <input type="text" name="managerName"placeholder="Name"></label>
624
                    <label for="">Mobile
625
                        <input type="text" name="managerNo" pattern="[0-9]{10}" title="Please enter Valid Mobile number" placeholder="Mobile No"> </label>  
626
                    <label for="">Email
627
                        <input type="email" name="managerEmail"size="25px" placeholder="Emailid"> </label>  
628
 
629
                    </div>
630
 
631
 
632
            <h4 class="page-header">8. Manpower Details</h4>
633
 
634
               <div class="form-group">
635
                    <label for="">Number of Employees
636
                    <input type="text" pattern="[0-9]" name="noOfEmployees"placeholder="Number of Employees"></label>
637
                    <label for="">Number of Management Staff
638
                        <input type="text" pattern="[0-9]" name="managementStaff" placeholder="Management Staff"> </label>  
639
 
640
                    </div>
641
 
642
              <h4 class="page-header">9. Experience In Telecom Trade/other Trade (Brand & Product Category)</h4>
643
                <div class="bcontacts">
644
                   <textarea rows="4" name="experienceinTelecome"cols="50" placeholder="Describe yourself here..."></textarea> 
645
                </div>
646
 
647
            <h4 class="page-header">10. Description of Existing Business & Annual Turnover</h4>
648
                <div class="bcontacts">
649
                      <textarea rows="4" name="descriptionofExistingBusiness"cols="50" placeholder="Describe yourself here..."></textarea>
650
                </div>
651
                <p>Please Provide ITR of last Two years</p>
652
                <div class = "form-group file upload"> 
653
                   <input type="file" accept="application/pdf,image/*" name ="doc_itrDoc">
654
                      <input type="hidden" name="itrDoc"/>
655
                    </div>
656
 
657
 
658
            <h4 class="page-header">11.Business Model</h4>
659
 
660
            <div class="btn-group">
661
                    <label class="btn btn-default">
662
                   <input type="radio" name="businessModel" value="Retailer" required>
663
                   <span>Retailer</span>
664
                  </label>
665
                <label class="btn btn-default">
666
                    <input type="radio" name="businessModel" value="Distributor" required>
667
                    <span>Distributor</span>
668
                </label>
669
                <label class="btn btn-default">
670
                    <input type="radio" name="businessModel" value="Franchises" required>
671
                    <span>Franchise</span>
672
                </label>
673
                  <label class="btn btn-default">
674
                    <input type="radio" name="businessModel" value="Other" required>
675
                    <span>Other</span>
676
                </label>
677
              </div>
678
 
679
 
680
          <h4 class="page-header">12. Selling Online (if yes, please specify Portal Names)</h4>
681
 
682
                    <div class="btn-group">
683
                    <label class="btn btn-default">
684
                   <input type="radio" name="sellingOnline" value="yes">
685
                   <span>Yes</span>
686
                  </label>
687
                <label class="btn btn-default">
688
                    <input type="radio" name="sellingOnline" value="no">
689
                    <span>No</span>
690
                </label>
691
              </div>
692
                   <div class="form-group portal Names" id = "sellingyes">
693
                   <label>Portal Names</label>
694
                       <input type="text" name="portalName1" size="25">
695
                       <input type="text" name="portalName2" size="25">
696
                       <input type="text" name="portalName3" size="25">
697
                  </div>
698
            <h4 class="page-header">13. Area of Shop(in Sq Feet)</h4>
699
              <div>
700
                 <div class="form-group">
701
                    <label>
702
 
703
                    <input type="number" name="east"  placeholder="East(Sq Feet)">
704
                    <input type="number" name="west"  placeholder="West(Sq Feet)">
705
                    <input type="number" name="north" placeholder="North(Sq Feet)"> 
706
                    </label>
707
                </div>
708
                    <br>
709
                      <div class="form-group">
710
                    <label>
711
 
712
                    <input type="number" name="south" placeholder="South(Sq Feet)">
713
                    <input type="number" name="front" placeholder="Front(Sq Feet)">
714
                    <input type="number" name="roadSize" placeholder="Road Size in Front(Sq Feet)">
715
 
716
                    </label>
717
                </div>
718
 
719
                  </div>  
720
                  <div class="shopArea">
721
                   <div class="btn-group">
722
                    <label class="btn btn-default">
723
                   <input type="radio" name="shopArea" value="Singleside">
724
                   <span>Single Side</span>
725
                  </label>
726
                <label class="btn btn-default">
727
                    <input type="radio" name="shopArea" value"Twoside">
728
                    <span>Two Side</span>
729
                </label>
730
                  <label class="btn btn-default">
731
                    <input type="radio" name="shopArea" value="Corner">
732
                    <span>Corner</span>
733
                </label>
734
              </div>
735
              </div>
736
 
737
 
738
              <h4 class="page-header">14. Status of Shop</h4>
739
 
740
                 <div class="btn-group">
741
                    <label class="btn btn-default">
742
                   <input type="radio" name="shopStatus" value="semifurnished">
743
                   <span>Semi Furnished</span>
744
                  </label>
745
                <label class="btn btn-default">
746
                    <input type="radio" name="shopStatus" value="fullfurnished">
747
                    <span>Fully Furnished</span>
748
                </label>
749
                </div>
750
 
751
                 <div class="checkboxes status" id ="shopsemifurnished">
752
                 <div class="btn btn-default">
753
   <label for="success1" class="btn btn-success">Flooring<input type="checkbox" name="flooring" 
754
          value ="flooring" id="success1" class="badgebox"><span class="badge">&check;</span></label>
755
        <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>
756
 
757
 
758
              </div>
759
            </div>
760
 
761
<div class ="checkboxes status"  id ="shopfullfurnished">
762
          <div class="row text-center">
763
    <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>
764
        <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>
765
        <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>
766
        <label for="success" class="btn btn-success">Electricity<input type="checkbox" name="electricity" 
767
          value ="yes" id="success" class="badgebox"><span class="badge">&check;</span></label>
768
        <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>
769
  </div>
770
    </div>
771
 
772
 
773
              <h4 class="page-header">15. Shop Available At</h4>
774
 
775
                     <div class="btn-group">
776
                    <label class="btn btn-default">
777
                   <input type="radio" name="shopAvailbility" value="Basement">
778
                   <span>Basement</span>
779
                  </label>
780
                <label class="btn btn-default">
781
                    <input type="radio" name="shopAvailbility" value="Groundfloor">
782
                    <span>Ground Floor</span>
783
                </label>
784
                  <label class="btn btn-default">
785
                    <input type="radio" name="shopAvailbility" value="firstfloor">
786
                    <span>First Floor</span>
787
                </label>
788
 
789
                  <label class="btn btn-default">
790
                    <input type="radio" name="shopAvailbility" value="secondfloor">
791
                    <span>Second Floor</span>
792
                </label>
793
 
794
                 <label class="btn btn-default">
795
                    <input type="radio" name="shopAvailbility" value="thirdfloor">
796
                    <span>Third Floor</span>
797
                </label>
798
                </div>
799
 
800
                <div class="form-group bdetail">
801
                   <p>Provide pictures of the shop from 3 different angles, ceiling and flooring</p>
802
                      <input type="file" name="doc_angleDoc1" accept="application/pdf,image/*" >
803
                      <input type="hidden" name="angleDoc1"/>
804
                      <input type="file" name="doc_angleDoc2" accept="application/pdf,image/*" >
805
                      <input type="hidden" name="angleDoc2"/>
806
                      <input type="file" name="doc_angleDoc3"  accept="application/pdf,image/*" >
807
                      <input type="hidden" name="angleDoc3"/>
808
                      <input type="file" name="doc_angleDoc4"  accept="application/pdf,image/*" >
809
                      <input type="hidden" name="angleDoc4"/>
810
                      <input type="file" name="doc_angleDoc5" accept="application/pdf,image/*">
811
                      <input type="hidden" name="angleDoc5"/>
812
                  </div>
813
 
814
         <h4 class="page-header">16. Location of Shop</h4>
815
                        <div class="btn-group">
816
                    <label class="btn btn-default">
817
                   <input type="radio" name="location" value="shoppingMall">
818
                   <span>Shopping Mall</span>
819
                  </label>
820
                <label class="btn btn-default">
821
                    <input type="radio" name="location" value="MainMobileMarket">
822
                    <span>Main Mobile Market</span>
823
                </label>
824
                  <label class="btn btn-default">
825
                    <input type="radio" name="location" value="LocalMarket">
826
                    <span>Local Market</span>
827
                </label>
828
 
829
                </div>
830
 
831
 
832
 
833
             <h4 class="page-header">17.Nearest Mobile Store</h4>
834
                           <div class="btn-group">
835
                    <label class="btn btn-default">
836
                   <input type="radio" name="nearestStore" value="100mtrs">
837
                   <span>100Mtrs</span>
838
                  </label>
839
                <label class="btn btn-default">
840
                    <input type="radio" name="nearestStore" value="200mtrs">
841
                    <span>200Mtrs</span>
842
                </label>
843
                  <label class="btn btn-default">
844
                    <input type="radio" name="nearestStore" value="500mtrs">
845
                    <span>500Mtrs</span>
846
                </label>
847
 
848
                </div>
849
 
850
                 <div class="form-group location">
851
                   <label>Name of the Shop</label>
852
                       <input type="text" size ="35" name="storeName">
853
                       <br>
854
                       <br>
855
                        <label>Address of the Shop</label>
856
                       <input type="text" size ="65" name="storeAddress">
857
                  </div>
858
 
859
 
860
 
861
            <h4 class="page-header">18. Ownership of Shop</h4>
862
 
863
                    <div class="btn-group">
864
                    <label class="btn btn-default">
865
                   <input type="radio" name="ownership" value="Selfowned">
866
                   <span>Self Owned</span>
867
                  </label>
868
                <label class="btn btn-default">
869
                    <input type="radio" name="ownership" value="Rented">
870
                    <span>Rented</span>
871
                </label>
872
                  <label class="btn btn-default">
873
                    <input type="radio" name="ownership" value="lease">
874
                    <span>Lease</span>
875
                </label>
876
                  </label>
877
                  <label class="btn btn-default">
878
                    <input type="radio" name="ownership" value="collaboration">
879
                    <span>Collaboration</span>
880
                </label>
881
 
882
                </div>
883
 
884
                 <div class="form-group bdetail">
885
                   <p>Provide relevant documents (Electricity bill/Rent Agreement/Lease Deed)to prove the status of ownership</p>
886
                     <input type="file" accept="application/pdf,image/*" name="doc_ownershipDoc">
887
                     <input type="hidden" name="ownershipDoc"/>
888
                   </div>
889
 
890
 
891
           <h4 class="page-header">19. Insurance of Shop (if yes, please provide the copy of the same)</h4>
892
 
893
 
894
                    <div class="btn-group">
895
                    <label class="btn btn-default">
896
                   <input type="radio" name="insurance" value="yes">
897
                   <span>Yes</span>
898
                  </label>
899
                <label class="btn btn-default">
900
                    <input type="radio" name="insurance" value="no">
901
                    <span>No</span>
902
                </label>
903
              </div>
904
 
905
                 <div class="form-group insurance doc"  id= "docyes">
906
                  <p>Please provide copy of insurance document</p>
907
                     <input type="file" accept="application/pdf,image/*" name="doc_insuranceDoc">
908
                      <input type="hidden" name="insuranceDoc"/>
909
                   </div>
910
 
911
 
912
         <h4 class="page-header">20. Loan on Shop (LAP/BL/CC/others)</h4>
913
 
914
                     <div class="btn-group">
915
                    <label class="btn btn-default">
916
                   <input type="radio" name="loan" value="yes">
917
                   <span>Yes</span>
918
                  </label>
919
                <label class="btn btn-default">
920
                    <input type="radio" name="loan" value="no">
921
                    <span>No</span>
922
                </label>
923
              </div>
924
 
925
                 <div class="form-group loan document" id ="documentyes">
926
                  <p>Please provide current statement Letter</p>
927
                     <input type="file" accept="application/pdf,image/*" name="doc_loanDoc">
928
                     <input type="hidden" name="loanDoc"/>
929
                      <p>Please provide current sanction Letter</p>
930
                     <input type="file" accept="application/pdf,image/*" name="doc_sanctionDoc">
931
                     <input type="hidden" name="sanctionDoc"/>
932
                   </div>
933
 
934
 
935
            <h4 class="page-header">21. Bank Name & Address</h4>
936
 
937
                  <div class="form-group float-label-control">
938
                        <label for="">Account Number</label>
939
                        <input type="text" name="accountNumber"class="form-control" placeholder="Account Number">
940
                    </div>
941
                     <div class="form-group float-label-control">
942
                        <label for="">Bank Name</label>
943
                        <input type="text" name="bankName"class="form-control" placeholder="Bank Name">
944
                    </div>
945
                     <div class="form-group float-label-control">
946
                        <label for="">IFSC Code</label>
947
                        <input type="text" name="ifscCode"class="form-control" placeholder="IFSC Code">
948
                    </div>
949
                     <div class="form-group float-label-control">
950
                        <label for="">Branch Name</label>
951
                        <input type="text" name="branchName" class="form-control" placeholder="Branch Name">
952
                    </div>
953
                     <div >
954
                  <p>Please attach the copy of cancelled cheque</p>
955
                      <div class="form-group">
956
                     <input type="file" name="doc_chequeCopy" accept="application/pdf,image/*">
957
                     <input type="hidden" name="chequeCopy"/>
958
                   </div>
959
 
960
 
961
                  <h4 class="page-header">22. HSPS Bank Account Detail</h4> 
962
 
963
                  <p>Please deposit amount of <strong> Rs 1 Lac </strong>as advance payment in following account through NEFT and submit the UTR No.</p>
964
                    <div class="form-group float-label-control">
965
                        <label for="">UTR Number</label>
966
                        <input type="text" name="utr" class="form-control" placeholder="UTR No">
967
                    </div>
968
                    <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>
969
 
970
 
971
 
972
                      <div class ="Account">
973
                      <label>Account Name: New Spice Solutions Pvt Ltd</label><br>
974
                       <label>Bank Name: IndusInd Bank Ltd.</label><br>
975
                        <label>Account No.:201000488351</label><br>
976
                        <label>Branch:M-56, Greater Kailash-II, Main Market New Delhi-110048</label><br>
977
                         <label>IFSC:INDB0000012</label><br>
978
                        </div>
979
 
980
                <div class="submit">
981
                    <button type="submit" class="btn btn-success btn-lg">Submit</button>
982
                </div>
983
 
984
                <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>
985
 
986
 
987
 
988
 
989
 <!--             <fieldset hidden disabled="disabled">
990
              <h4 class="page-header">PMP STORE REGISTRATION APPROVAL</h4>
991
                 <p>(FOR OFFICE USE ONLY)</P>
992
 
993
                <div class=breg>
994
                 <div class=bApproval>
995
 
996
                  <label>Recommended by</label>
997
                  <input type="text" name = "recommended"class="reg-control" size="50">
998
 
999
                  </div>
1000
                  <br>
1001
 
1002
                    <div class=bApproval>
1003
                  <label>Business Manager</label>
1004
                  <input type="text" name=" bManager" class="reg-control" size="50">
1005
                </div>
1006
                      <br>
1007
                        <div class=bApproval>
1008
                    <label>Operations Manager</label>
1009
                  <input type="text"name="operation"class="reg-control"  size="50">
1010
                </div>
1011
                  <br>
1012
               <div class=bApproval>
1013
                     <label>BusinessHeadCategoryHead</label>
1014
                  <input type="text" name="bhead"class="reg-control" size="50">
1015
                </div>
1016
 
1017
 
1018
                 </div>
1019
               </fieldset> -->
1020
 
1021
                      </form>
1022
                    </div>
1023
          </div>
1024
   <div class="col-sm-4">
1025
                <div class="panel panel-default">
1026
 
1027
                    <div class="panel-body">
1028
 
1029
 
1030
                   <label>Spice Global Knowledge Park - 6th Floor, Plot No.19A & 19B, Sector 125, Noida, UP - 201301</label>
1031
                   <br>
1032
                    <label>Email - care@profitmandi.com</<label>
1033
                    <br> 
1034
                    <label>Contact - 8588842949 </label>
1035
                    </div>
1036
                </div>
1037
            </div>
1038
 
1039
        </div>
1040
 
1041
    </div>
1042
    </div>
1043
</body>
1044
</html>