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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>
22191 amit.gupta 15
<script src="resources/fofo-form/js/fofoedit.js"></script>
22095 kshitij.so 16
<script src="resources/fofo-form/js/jquery.blockUI.js"></script>
17
<script type="text/javascript">
22155 amit.gupta 18
contexPath = "${rc.contextPath}";
22191 amit.gupta 19
var jsonObj= "$fofoForm";
22095 kshitij.so 20
 $(document).ready(function(){
22191 amit.gupta 21
	readForm();
22095 kshitij.so 22
    $("input[name$='bEntity']").click(function() {
23
        var test1 = $(this).val();
24
       $(".box").hide();
25
       $('input[name=dinNumber]').each(function(){
26
         $(this).prop('disabled', true);
27
      });
28
 
29
       var dinNumberInput = $("#sale"+test1+ " input[name=dinNumber]");
30
       if (dinNumberInput.prop('disabled') == true){
31
            dinNumberInput.prop('disabled', false);
32
       } 
33
        $("#sale" + test1).show();
34
});
35
});
36
</script>
37
 
38
<script type="text/javascript">
39
$(document).ready(function(){
40
    $("input[name$='bPmpDetail']").click(function() {
41
        var test1 = $(this).val();
42
       $(".pmp").hide();
43
        $("#Pmp" + test1).show();
44
    });
45
});
46
 
47
</script>
48
 
49
<script type="text/javascript">
50
$(document).ready(function(){
51
    $("input[name$='shopStatus']").click(function() {
52
        var test1 = $(this).val();
53
          $("#shopsemifurnished, #shopfullfurnished").find("input[type=checkbox]").each(function(){
54
         $(this).prop('disabled', true);
55
    });
56
 
57
       $(".status").hide();
58
       $("#shop" + test1).show();
59
       $("#shop" + test1).find("input[type=checkbox]").prop('disabled', false);
60
 
61
 
62
 
63
 
64
    });
65
});
66
 
67
</script>
68
<script type="text/javascript">
69
$(document).ready(function(){
70
    $("input[name$='sellingOnline']").click(function() {
71
        var test1 = $(this).val();
72
       $(".Names").hide();
73
        $("#selling" + test1).show();
74
    });
75
});
76
 
77
</script>
78
 
79
 
80
<script type="text/javascript">
81
$(document).ready(function(){
82
    associateValidator();
83
    $("input[name$='insurance']").click(function() {
84
        var test1 = $(this).val();
85
       $(".doc").hide();
86
        $("#doc" + test1).show();
87
    });
88
});
89
 
90
</script>
91
 
92
<script type="text/javascript">
22155 amit.gupta 93
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 94
$(document).ready(function(){
95
    $("input[name$='loan']").click(function() {
96
        var test1 = $(this).val();
97
       $(".document").hide();
98
        $("#document" + test1).show();
99
        $("#showHide").show();
100
    });
101
 
102
  docsArray.forEach(function(inputName){
103
 
104
	   $('input[name="' + inputName + '"]').change(function(e){
105
	    var formData = new FormData();
106
	    that = this;
107
		formData.append("file", $(this)[0].files[0]);
108
		jQuery.ajax({
22186 amit.gupta 109
	          url: window.location.hostname + ":8080/profitmandi-web/document-upload",
22095 kshitij.so 110
	          type: 'POST',
111
	          data: formData,
112
	          	cache: false,
113
            contentType: false,
114
            processData: false,
115
	            processData: false,
116
	           success: function (data) {
117
	           console.log(data);
118
	           	hiddenInput = inputName.split("_")[1];
119
	           	var doc_id = 0;
120
	           	if (data.response.document_id == 0){
121
	           		alert(data.response.message);
122
	           		return;
123
	           	}
124
	               $('input[name="' + hiddenInput + '"]').val(data.response.document_id);
22152 amit.gupta 125
	               validator.data('bootstrapValidator').revalidateField($('input[name="' + hiddenInput + '"]'));
22095 kshitij.so 126
	           }
127
	    });
128
	});
129
 
130
  });
131
});
132
 
133
function queryStringToJSON(queryString) {
134
  var pairs = queryString.split('&');
135
  var result = {};
136
  pairs.forEach(function(pair) {
137
    pair = pair.split('=');
138
    result[pair[0]] = decodeURIComponent(pair[1] || '');
139
 
140
  });
141
  return result;
142
}
143
 
22148 amit.gupta 144
/*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 145
 
146
function jQFormSerializeArrToJson(formSerializeArr){
147
 var jsonObj = {};
148
 jQuery.map( formSerializeArr, function( n, i ) {
149
     jsonObj[n.name] = n.value;
150
 });
151
 return jsonObj;
152
}
153
 
154
</script>
155
 
156
<style>
157
.loading-image {
158
position: fixed;
159
top: 50%;
160
left: 50%;
161
margin-top: -50px;
162
margin-left: -100px;
163
z-index: 100;
164
}
165
</style>
166
 
167
</head>
168
 
169
<body>
170
<div class="container">
171
    <div class="row">
172
         <div class ="header">   
173
		 <h3 class="header">HOTSPOT PARTNER STORE</h3>
174
         <h4 class="header">Powered by Profit Mandi (A Unit of Spice Group)</h4>
175
         </div>
176
 
177
        <div class="header">
178
            <h5 class="header">APPLICATION FOR REGISTRATION</h5>
179
       </div>  
180
        <hr />
181
 
182
        <div class="row">
183
            <div class="col-sm-8">
184
 
185
                <form role="form" name="myform" id ="form"  enctype="multipart/form-data"  data-toggle="validator" novalidate>
22191 amit.gupta 186
                <input tye="hidden" name="_id" value="0"/>
22095 kshitij.so 187
             <h4 class="page-header">1. Registered Business Name of HSPS (in Block Letters)</h4>
188
                     <div class="form-group ">
189
 
190
                     <label for=""></label>
191
                     <input type="text" name="registeredBusinessName" style="text-transform:uppercase;" id="demo" class="bform" placeholder="Business Name"/>
192
                     </div>
193
 
194
 
195
             <h4 class="page-header">2. Registered Address (In Block Letters)</h4>
196
 
197
                    <div class="form-group float-label-control">
198
                        <label for="">Line 1</label>
199
                        <input type="text" name ="line1" class="form-control" placeholder="Line 1">
200
                    </div>
201
                     <div class="form-group float-label-control">
202
                        <label for="">Line 2</label>
203
                        <input type="text" name ="line2"class="form-control" placeholder="Line 2">
204
                    </div>
205
                     <div class="form-group float-label-control">
206
                        <label for="">Line 3</label>
207
                        <input type="text" name="line3" class="form-control" placeholder="Line 3">
208
                    </div>
209
                     <div class="form-group float-label-control">
210
                        <label for="">City</label>
211
                        <input type="text" name="city" class="form-control" placeholder="City">
212
                    </div>
213
                      <div class="form-group float-label-control">
214
                        <label for="">District</label>
215
                        <input type="text" name="district" class="form-control" placeholder="District">
216
                    </div>
217
                     <div class="form-group float-label-control">
218
                        <label for="">Pincode</label>
219
                        <input  type="text" name="pincode" maxlength="6" class="form-control" pattern="[0-9]{6}" title="Please enter correct Pin Code"placeholder="Pincode">
220
                      </div>  
221
 
222
                     <div class="form-group float-label-control">
223
 
224
                      <select class="form-control" name = "state" placeholder="State">
225
                       <option value=" ">State</option>
226
                     <option value="Andaman and Nicobar Islands">Andaman and Nicobar Islands</option>
227
                            <option value="Andhra Pradesh">Andhra Pradesh</option>
228
                            <option value="Arunachal Pradesh">Arunachal Pradesh</option>
229
                            <option value="Assam">Assam</option>
230
                            <option value="Bihar">Bihar</option>
231
                            <option value="Chandigarh">Chandigarh</option>
232
                            <option value="Chhattisgarh">Chhattisgarh</option>
233
                            <option value="Dadra and Nagar Haveli">Dadra and Nagar Haveli</option>
234
                            <option value="Daman and Diu">Daman and Diu</option>
235
                            <option value="Delhi">Delhi</option>
236
                            <option value="Goa">Goa</option>
237
                            <option value="Gujarat">Gujarat</option>
238
                            <option value="Haryana">Haryana</option>
239
                            <option value="Himachal Pradesh">Himachal Pradesh</option>
240
                            <option value="Jammu and Kashmir">Jammu and Kashmir</option>
241
                            <option value="Jharkhand">Jharkhand</option>
242
                            <option value="Karnataka">Karnataka</option>
243
                            <option value="Kerala">Kerala</option>
244
                            <option value="Lakshadweep">Lakshadweep</option>
245
                            <option value="Madhya Pradesh">Madhya Pradesh</option>
246
                            <option value="Maharashtra">Maharashtra</option>
247
                            <option value="Manipur">Manipur</option>
248
                            <option value="Meghalaya">Meghalaya</option>
249
                            <option value="Mizoram">Mizoram</option>
250
                            <option value="Nagaland">Nagaland</option>
251
                            <option value="Orissa">Orissa</option>
252
                            <option value="Pondicherry">Pondicherry</option>
253
                            <option value="Punjab">Punjab</option>
254
                            <option value="Rajasthan">Rajasthan</option>
255
                            <option value="Sikkim">Sikkim</option>
256
                            <option value="Tamil Nadu">Tamil Nadu</option>
257
                            <option value="Tripura">Tripura</option>
258
                            <option value="Telangana">Telangana</option>
259
                            <option value="Uttaranchal">Uttaranchal</option>
260
                            <option value="Uttar Pradesh">Uttar Pradesh</option>
261
                            <option value="West Bengal">West Bengal</option>
262
                                              </select>
263
                    </div>
264
 
265
 
266
                      <div class="form-group float-label-control">
267
                        <label for="">Email1</label>
22139 amit.gupta 268
                        <input type="email" class="form-control" name="registeredEmail1" placeholder="Email1" readonly value="${email}">
22095 kshitij.so 269
                      </div>  
270
                         <p>Example:- xyz<strong>.hsps@gmail.com</strong></p>
271
 
272
 
273
 
274
                        <div class="form-group float-label-control">
275
                        <label for="">Email2</label>
276
                        <input type="email" class="form-control" name="registeredEmail2" placeholder="Email2">
277
                      </div> 
278
 
279
 
280
                       <div class="form-group float-label-control">
281
                        <label for="">Mobile</label>
282
                        <input  type="text" class="form-control" name="mobile" maxlength = "10" pattern="[0-9]{10}" title="Please enter valid Phone number" placeholder="Mobile">
283
                      </div>  
284
 
285
                    <label>Landline</label>
286
                      <div class="form-group Pmpform">
287
                      <input type="text" name="stdcode" maxlength = "5" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="STDcode"/> 
288
 
289
 
290
                      <input type="text" name="telephone" maxlength = "10" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="Telephone"/>
291
                      </div>
292
 
293
 
294
 
295
             <h4 class="page-header">3. Type of Business Entity</h4>
296
 
297
                   <div class="funkyradio">
298
 
299
                    <div class="funkyradio-primary">
300
                        <input type="radio" name="bEntity" id="radio1" value="SaleProprietorship" required>
301
                        <label for="radio1">Proprietor</label>
302
                    </div>
303
                    <div class="funkyradio-primary">
304
                        <input type="radio" name="bEntity" id="radio2" value="Partnership" required>
305
                        <label for="radio2">Partnership</label>
306
                    </div>
307
                    <div class="funkyradio-primary">
308
                        <input type="radio" name="bEntity" id="radio3" value="PrivateLimitedCompany" required>
309
                        <label for="radio3">Private Limited company</label>
310
                    </div>
311
                    <div class="funkyradio-primary">
312
                        <input type="radio" name="bEntity" id="radio4" value="LimitedLiabilityPartnership" required>
313
                        <label for="radio4">Limited Liability Partnership</label>
314
                    </div>
315
                </div>
316
                  <div class ="Entity">
317
                    <div class="SaleProprietorship box" id ="saleSaleProprietorship">Upload <strong>Proprietership proof</strong></div>
318
                     <div class="partnership box" id="salePartnership">Upload <strong>Partnership Deed</strong></div>
319
                     </div>
320
                      <div class="limitedcompany box" id="salePrivateLimitedCompany">
321
                      <div class="form-group float-label-control">
322
                        <label for="">DIN Number</label>
323
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number">
324
                    </div>Upload <strong>Incorporation certificate,Memorandum & Article of association</strong>
325
                      </div>
326
 
327
 
328
                      <div class="LimitedLiabilityPartnership box" id="saleLimitedLiabilityPartnership">
329
 
330
 
331
                           <div class="form-group float-label-control">
332
                        <label for="">DIN Number</label>
333
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number">
334
                    </div>Upload <strong>Registration certificate & partnership Deed</strong>
335
                     </div>
336
 
337
                    <div class = "form-group file upload"> 
338
                   <input type="file" accept="application/pdf,image/*" id="doc" name ="doc_bEntityDoc">
339
 
340
                   <input type="hidden" name="bEntityDoc"/>
341
                    </div>
342
 
343
                     <h4 class="page-header">4. Goods And Services Tax Number(GST)</h4>
344
                    <div class="Pmpform">
345
 
346
                        <input type="text" name="gst" class="bform" placeholder="Goods And Services Tax Number"/>
347
                    </div>
348
                     <p>Provide Copy of GST document</p>
349
                    <div class = "file upload"> 
350
                   <input type="file"  accept="application/pdf,image/*" name ="doc_gstDoc">
351
                     <input type="hidden" name="gstDoc"/>
352
                    </div>
353
 
354
 
355
                     <h4 class="page-header">5. Permanent Account Number(PAN)</h4>
356
                    <div class="form-group ">
357
 
358
                     <label for=""></label>
359
                     <input type="text" name="pan" maxlength="10" class="bform" placeholder="Permanent Account Number"/></div>
360
                     <p>Provide Copy of PAN </p>
361
 
362
                    <div class = "form-group file upload"> 
363
 
364
                   <input type="file" accept="application/pdf,image/*" name="doc_panDoc">
365
                     <input type="hidden" name="panDoc"/>
366
                    </div>
367
 
368
 
369
             <h4 class="page-header">6. Full Details Of Business Entity</h4>
370
 
371
                   <div class="funkyradio">
372
                    <div class="funkyradio-primary">
373
                        <input type="radio" name="bPmpDetail" id="business1" value="Proprietor" required>
374
                        <label for="business1">Proprietor</label>
375
                    </div>
376
                    <div class="funkyradio-primary">
377
                        <input type="radio" name="bPmpDetail" id="business2" value="Partners" required>
378
                        <label for="business2">Partners</label>
379
                    </div>
380
                    <div class="funkyradio-primary">
381
                        <input type="radio" name="bPmpDetail" id="business3" value="Directors" required>
382
                        <label for="business3">Directors</label>
383
                    </div>
384
                </div>
385
 
386
                <div class="tablecontainer">
387
   <table class="businessdetail">
388
              <tr> 
389
              <th class ="PMPName">Name</th>
390
              <th  class="PMPAddress">Address</th> 
391
              <th class="PMPtelno">Mobile</th>
392
              <th class="PMPpan">PAN</th>
393
              <th class="PMPAdhaar">Aadhaar Number</th>
394
              <th class="PMPemail">Email</th>
395
              <th class="PMPownership">Share %</th>
396
 
397
               </tr>
398
            <tr>
399
 
400
                   <td class="form-group"><input type="text" name="proprietorBusineesName"size="25"></td>
401
                   <td class="form-group"><textarea row="3" name="proprietorAddress"></textarea></td>
402
                   <td class="form-group"><input type="text" name="proprietorPhone" maxlength="10" pattern="[0-9]{10}"size="10"></th>
403
                   <td class="form-group"><input type="text" name="proprietorPan" maxlength="10" title="Please enter correct pan number"size="10"></td>
404
                    <td class="form-group"><input type="text"  name= "proprietorAdhaar" size="15"></td>
405
                   <td class="form-group"><input type="email"  name= "proprietorEmail" size="20"></td>
406
                   <td class="form-group"><input type="text" pattern="[0-9]" name="proprietorOwner" size="10"></td>
407
 
408
                   </tr>
409
 
410
 
411
            </table>
412
 
413
            </div>
414
            <div class="Partners pmp" id= "PmpPartners">
415
            <table class="businessdetail">
416
 
417
             <tr> 
418
              <th class ="PMPName">Name</th>
419
              <th  class="PMPAddress">Address</th> 
420
              <th class="PMPtelno">Mobile</th>
421
              <th class="PMPpan">PAN</th>
422
              <th class="PMPAdhaar">Aadhaar Number</th>
423
              <th class="PMPemail">Email</th>
424
              <th class="PMPownership">Share %</th>
425
 
426
               </tr>
427
                <tr>
428
 
429
                   <td class="form-group"><input name="partnerName1"type="text" size="25"></td>
430
                   <td class="form-group"><textarea name="partnerAddress1" type="text" size="60"></textarea></td>
431
                   <td class="form-group"><input name = "partnerPhone1" pattern="[0-9]{10}"type="text" size="10"></th>
432
                   <td class="form-group"><input  name ="partnerPan1"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
433
                    <td class="form-group"><input name="partnerAdhaar1" type="text"  size="15"></td>
434
                   <td class="form-group"><input name="partnerEmail1" type="email"  size="20"></td>
435
                   <td class="form-group"><input name="partnerOwner1" type="text"pattern="[0-9]"size="10"></td>
436
 
437
                   </tr>
438
 
439
 
440
            </table>
441
 
442
                   <table class="businessdetail">
443
 
444
             <tr> 
445
              <th class ="PMPName">Name</th>
446
              <th  class="PMPAddress">Address</th> 
447
              <th class="PMPtelno">Mobile</th>
448
              <th class="PMPpan">PAN</th>
449
              <th class="PMPAdhaar">Aadhaar Number</th>
450
              <th class="PMPemail">Email</th>
451
              <th class="PMPownership">Share %</th>
452
 
453
               </tr>
454
              <tr>
455
 
456
                   <td class="form-group"><input name="partnerName2"type="text" size="25"></td>
457
                   <td class="form-group"><textarea name="partnerAddress2" type="text" size="60"></textarea></td>
458
                   <td class="form-group"><input name = "partnerPhone2" pattern="[0-9]{10}" type="text" size="10"></th>
459
                   <td class="businesspan"><input  name ="partnerPan2"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
460
                   <td class="form-group"><input name="partnerAdhaar2" type="text" size="15"></td>
461
                   <td class="form-group"><input name="partnerEmail2" type="email" size="20"></td>
462
                   <td class="form-group"><input name="partnerOwner2" pattern="[0-9]" type="text" size="10"></td>
463
 
464
                   </tr>
465
 
466
            </table>
467
                   <table class="businessdetail">
468
             <tr> 
469
            <th class ="PMPName">Name</th>
470
              <th  class="PMPAddress">Address</th> 
471
              <th class="PMPtelno">Mobile</th>
472
              <th class="PMPpan">PAN</th>
473
              <th class="PMPAdhaar">Aadhaar Number</th>
474
              <th class="PMPemail">Email</th>
475
              <th class="PMPownership">Share %</th>
476
 
477
               </tr>
478
                 <tr>
479
 
480
                   <td class="form-group"><input name="partnerName3"type="text" size="25"></td>
481
                   <td class="form-group"><textarea name="partnerAddress3" type="text" size="60"></textarea></td>
482
                   <td class="form-group"><input name = "partnerPhone3" type="text"  maxlength = "10" pattern="[0-9]{10}"  size="10"></th>
483
                   <td class="form-group"><input  name ="partnerPan3"type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
484
                    <td class="form-groupr"><input name="partnerAdhaar3" type="text" size="15"></td>
485
                   <td class="form-group"><input name="partnerEmail3"  type="email" size="20"></td>
486
                   <td class="form-group"><input name="partnerOwner3" pattern="[0-9"  type="text" size="10"></td>
487
 
488
                   </tr>
489
 
490
 
491
            </table>
492
 
493
 
494
 
495
           <table class="businessdetail">
496
       <tr> 
497
                <th class ="PMPName">Name</th>
498
              <th  class="PMPAddress">Address</th> 
499
              <th class="PMPtelno">Mobile</th>
500
              <th class="PMPpan">PAN</th>
501
              <th class="PMPAdhaar">Aadhaar Number</th>
502
              <th class="PMPemail">Email</th>
503
              <th class="PMPownership">Share %</th>
504
               </tr>
505
               <tr>
506
 
507
                   <td class="form-group"><input name="partnerName4"type="text" size="25"></td>
508
                   <td class="form-group"><textarea name="partnerAddress4" type="text" size="60"></textarea></td>
509
                   <td class="form-group"><input name = "partnerPhone4"  pattern="[0-9]{10}" type="text" size="10"></th>
510
                   <td class="form-group"><input  name ="partnerPan4"type="text" maxlength = "10"title="Please enter correct pan number"size="10"></td>
511
                    <td class="form-group"><input name="partnerAdhaar4" type="text" size="15"></td>
512
                   <td class="form-group"><input name="partnerEmail4" type="email" size="20"></td>
513
                   <td class="form-group"><input name="partnerOwner4" pattern="[0-9]" type="text" size="10"></td>
514
 
515
                   </tr>
516
 
517
 
518
            </table>
519
 
520
            </div>
521
 
522
 
523
             <div class="Directors pmp" id= "PmpDirectors">
524
            <table class="businessdetail">
525
               <tr> 
526
               <th class ="PMPName">Name</th>
527
              <th  class="PMPAddress">Address</th> 
528
              <th class="PMPtelno">Mobile</th>
529
              <th class="PMPpan">PAN</th>
530
              <th class="PMPAdhaar">Aadhaar Number</th>
531
              <th class="PMPemail">Email</th>
532
              <th class="PMPownership">Share %</th>
533
 
534
               </tr>
535
               <tr>
536
                   <td class="form-group"><input name="shareholderName1"type="text" size="25"></td>
537
                   <td class="form-group"><textarea name="shareholderAddress1" type="text" size="60"></textarea></td>
538
                   <td class="form-group"><input name = "shareholderPhone1" pattern="[0-9]{10}" type="text" size="10"></th>
539
                   <td class="form-group"><input  name ="shareholderPan1"type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
540
                   <td class="form-group"><input name="shareholderAdhaar1" type="text" size="15"></td>
541
                   <td class="form-group"><input name="shareholderEmail1" type="email" size="20"></td>
542
                   <td class="form-group"><input name="shareholderOwner1" pattern="[0-9]" type="text" size="10"></td>
543
 
544
                   </tr>
545
 
546
 
547
            </table>
548
 
549
                   <table class="businessdetail">
550
          <tr> 
551
                <th class ="PMPName">Name</th>
552
              <th  class="PMPAddress">Address</th> 
553
              <th class="PMPtelno">Mobile</th>
554
              <th class="PMPpan">PAN</th>
555
              <th class="PMPAdhaar">Aadhaar Number</th>
556
              <th class="PMPemail">Email</th>
557
              <th class="PMPownership">Share %</th>
558
               </tr>
559
                 <tr>
560
                   <td class="form-group"><input name="shareholderName2"type="text" size="25"></td>
561
                   <td class="form-group"><textarea name="shareholderAddress2" type="text" size="60"></textarea></td>
562
                   <td class="form-group"><input name = "shareholderPhone2" pattern="[0-9]{10}" type="text" size="10"></th>
563
                   <td class="form-group"><input  name ="shareholderPan2"type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
564
                    <td class="form-group"><input name="shareholderAdhaar2" type="text" size="15"></td>
565
                   <td class="form-group"><input name="shareholderEmail2"  type="email" size="20"></td>
566
                   <td class="form-group"><input name="shareholderOwner2" pattern="[0-9]"  type="text" size="10"></td>
567
 
568
                   </tr>
569
            </table>
570
 
571
                   <table class="businessdetail">
572
              <tr> 
573
                <th class ="PMPName">Name</th>
574
              <th  class="PMPAddress">Address</th> 
575
              <th class="PMPtelno">Mobile</th>
576
              <th class="PMPpan">PAN</th>
577
              <th class="PMPAdhaar">Aadhaar Number</th>
578
              <th class="PMPemail">Email</th>
579
              <th class="PMPownership">Share %</th>
580
 
581
               </tr>
582
                   <tr>
583
                   <td class="form-group"><input name="shareholderName3"type="text" size="25"></td>
584
                   <td class="form-group"><textarea name="shareholderAddress3" type="text" size="60"></textarea></td>
585
                   <td class="form-group"><input name = "shareholderPhone3" pattern="[0-9]{10}" type="text" size="10"></th>
586
                   <td class="form-group"><input  name ="shareholderPan3" type="text" maxlength = "10" title="Please enter correct pan number"size="10"></td>
587
                   <td class="form-group"><input name="shareholderAdhaar3" type="text" size="15"></td>
588
                   <td class="form-group"><input name="shareholderEmail3" type="email" size="20"></td>
589
                   <td class="form-group"><input name="shareholderOwner3" pattern="[0-9]" type="text" size="10"></td>
590
 
591
                   </tr>
592
 
593
            </table>
594
 
595
                   <table class="businessdetail">
596
             <tr> 
597
                <th class ="PMPName">Name</th>
598
              <th  class="PMPAddress">Address</th> 
599
              <th class="PMPtelno">Mobile</th>
600
              <th class="PMPpan">PAN</th>
601
              <th class="PMPAdhaar">Aadhaar Number</th>
602
              <th class="PMPemail">Email</th>
603
              <th class="PMPownership">Share %</th>
604
               </tr>
605
                     <tr>
606
                   <td class="form-group"><input name="shareholderName4" type="text" size="25"></td>
607
                   <td class="form-group"><textarea name="shareholderAddress4" type="text" size="60"></textarea></td>
608
                   <td class="form-group"><input name = "shareholderPhone4" type="text" pattern="[0-9]{10}" size="10"></th>
609
                   <td class="form-group"><input  name ="shareholderPan4" type="text" maxlength = "10"  title="Please enter correct pan number"size="10"></td>
610
                    <td class="form-group"><input name="shareholderAdhaar4" type="text" size="15"></td>
611
                   <td class="form-group"><input name="shareholderEmail4"  type="email" size="20"></td>
612
                   <td class="form-group"><input name="shareholderOwner4" pattern="[0-9]"  type="text" size="10"></td>
613
 
614
                   </tr>
615
 
616
 
617
            </table>
618
 
619
            </div>
620
 
621
         <h4 class="page-header">7. Store Manager Details</h4>
622
 
623
 
624
                    <div class="form-group">
625
                    <label for="">Name
626
                    <input type="text" name="managerName"placeholder="Name"></label>
627
                    <label for="">Mobile
628
                        <input type="text" name="managerNo" pattern="[0-9]{10}" title="Please enter Valid Mobile number" placeholder="Mobile No"> </label>  
629
                    <label for="">Email
630
                        <input type="email" name="managerEmail"size="25px" placeholder="Emailid"> </label>  
631
 
632
                    </div>
633
 
634
 
635
            <h4 class="page-header">8. Manpower Details</h4>
636
 
637
               <div class="form-group">
638
                    <label for="">Number of Employees
639
                    <input type="text" pattern="[0-9]" name="noOfEmployees"placeholder="Number of Employees"></label>
640
                    <label for="">Number of Management Staff
641
                        <input type="text" pattern="[0-9]" name="managementStaff" placeholder="Management Staff"> </label>  
642
 
643
                    </div>
644
 
645
              <h4 class="page-header">9. Experience In Telecom Trade/other Trade (Brand & Product Category)</h4>
646
                <div class="bcontacts">
647
                   <textarea rows="4" name="experienceinTelecome"cols="50" placeholder="Describe yourself here..."></textarea> 
648
                </div>
649
 
650
            <h4 class="page-header">10. Description of Existing Business & Annual Turnover</h4>
651
                <div class="bcontacts">
652
                      <textarea rows="4" name="descriptionofExistingBusiness"cols="50" placeholder="Describe yourself here..."></textarea>
653
                </div>
654
                <p>Please Provide ITR of last Two years</p>
655
                <div class = "form-group file upload"> 
656
                   <input type="file" accept="application/pdf,image/*" name ="doc_itrDoc">
657
                      <input type="hidden" name="itrDoc"/>
658
                    </div>
659
 
660
 
661
            <h4 class="page-header">11.Business Model</h4>
662
 
663
            <div class="btn-group">
664
                    <label class="btn btn-default">
665
                   <input type="radio" name="businessModel" value="Retailer" required>
666
                   <span>Retailer</span>
667
                  </label>
668
                <label class="btn btn-default">
669
                    <input type="radio" name="businessModel" value="Distributor" required>
670
                    <span>Distributor</span>
671
                </label>
672
                <label class="btn btn-default">
673
                    <input type="radio" name="businessModel" value="Franchises" required>
674
                    <span>Franchise</span>
675
                </label>
676
                  <label class="btn btn-default">
677
                    <input type="radio" name="businessModel" value="Other" required>
678
                    <span>Other</span>
679
                </label>
680
              </div>
681
 
682
 
683
          <h4 class="page-header">12. Selling Online (if yes, please specify Portal Names)</h4>
684
 
685
                    <div class="btn-group">
686
                    <label class="btn btn-default">
687
                   <input type="radio" name="sellingOnline" value="yes">
688
                   <span>Yes</span>
689
                  </label>
690
                <label class="btn btn-default">
691
                    <input type="radio" name="sellingOnline" value="no">
692
                    <span>No</span>
693
                </label>
694
              </div>
695
                   <div class="form-group portal Names" id = "sellingyes">
696
                   <label>Portal Names</label>
697
                       <input type="text" name="portalName1" size="25">
698
                       <input type="text" name="portalName2" size="25">
699
                       <input type="text" name="portalName3" size="25">
700
                  </div>
701
            <h4 class="page-header">13. Area of Shop(in Sq Feet)</h4>
702
              <div>
703
                 <div class="form-group">
704
                    <label>
705
 
706
                    <input type="number" name="east"  placeholder="East(Sq Feet)">
707
                    <input type="number" name="west"  placeholder="West(Sq Feet)">
708
                    <input type="number" name="north" placeholder="North(Sq Feet)"> 
709
                    </label>
710
                </div>
711
                    <br>
712
                      <div class="form-group">
713
                    <label>
714
 
715
                    <input type="number" name="south" placeholder="South(Sq Feet)">
716
                    <input type="number" name="front" placeholder="Front(Sq Feet)">
717
                    <input type="number" name="roadSize" placeholder="Road Size in Front(Sq Feet)">
718
 
719
                    </label>
720
                </div>
721
 
722
                  </div>  
723
                  <div class="shopArea">
724
                   <div class="btn-group">
725
                    <label class="btn btn-default">
726
                   <input type="radio" name="shopArea" value="Singleside">
727
                   <span>Single Side</span>
728
                  </label>
729
                <label class="btn btn-default">
730
                    <input type="radio" name="shopArea" value"Twoside">
731
                    <span>Two Side</span>
732
                </label>
733
                  <label class="btn btn-default">
734
                    <input type="radio" name="shopArea" value="Corner">
735
                    <span>Corner</span>
736
                </label>
737
              </div>
738
              </div>
739
 
740
 
741
              <h4 class="page-header">14. Status of Shop</h4>
742
 
743
                 <div class="btn-group">
744
                    <label class="btn btn-default">
745
                   <input type="radio" name="shopStatus" value="semifurnished">
746
                   <span>Semi Furnished</span>
747
                  </label>
748
                <label class="btn btn-default">
749
                    <input type="radio" name="shopStatus" value="fullfurnished">
750
                    <span>Fully Furnished</span>
751
                </label>
752
                </div>
753
 
754
                 <div class="checkboxes status" id ="shopsemifurnished">
755
                 <div class="btn btn-default">
756
   <label for="success1" class="btn btn-success">Flooring<input type="checkbox" name="flooring" 
757
          value ="flooring" id="success1" class="badgebox"><span class="badge">&check;</span></label>
758
        <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>
759
 
760
 
761
              </div>
762
            </div>
763
 
764
<div class ="checkboxes status"  id ="shopfullfurnished">
765
          <div class="row text-center">
766
    <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>
767
        <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>
768
        <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>
769
        <label for="success" class="btn btn-success">Electricity<input type="checkbox" name="electricity" 
770
          value ="yes" id="success" class="badgebox"><span class="badge">&check;</span></label>
771
        <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>
772
  </div>
773
    </div>
774
 
775
 
776
              <h4 class="page-header">15. Shop Available At</h4>
777
 
778
                     <div class="btn-group">
779
                    <label class="btn btn-default">
780
                   <input type="radio" name="shopAvailbility" value="Basement">
781
                   <span>Basement</span>
782
                  </label>
783
                <label class="btn btn-default">
784
                    <input type="radio" name="shopAvailbility" value="Groundfloor">
785
                    <span>Ground Floor</span>
786
                </label>
787
                  <label class="btn btn-default">
788
                    <input type="radio" name="shopAvailbility" value="firstfloor">
789
                    <span>First Floor</span>
790
                </label>
791
 
792
                  <label class="btn btn-default">
793
                    <input type="radio" name="shopAvailbility" value="secondfloor">
794
                    <span>Second Floor</span>
795
                </label>
796
 
797
                 <label class="btn btn-default">
798
                    <input type="radio" name="shopAvailbility" value="thirdfloor">
799
                    <span>Third Floor</span>
800
                </label>
801
                </div>
802
 
803
                <div class="form-group bdetail">
804
                   <p>Provide pictures of the shop from 3 different angles, ceiling and flooring</p>
805
                      <input type="file" name="doc_angleDoc1" accept="application/pdf,image/*" >
806
                      <input type="hidden" name="angleDoc1"/>
807
                      <input type="file" name="doc_angleDoc2" accept="application/pdf,image/*" >
808
                      <input type="hidden" name="angleDoc2"/>
809
                      <input type="file" name="doc_angleDoc3"  accept="application/pdf,image/*" >
810
                      <input type="hidden" name="angleDoc3"/>
811
                      <input type="file" name="doc_angleDoc4"  accept="application/pdf,image/*" >
812
                      <input type="hidden" name="angleDoc4"/>
813
                      <input type="file" name="doc_angleDoc5" accept="application/pdf,image/*">
814
                      <input type="hidden" name="angleDoc5"/>
815
                  </div>
816
 
817
         <h4 class="page-header">16. Location of Shop</h4>
818
                        <div class="btn-group">
819
                    <label class="btn btn-default">
820
                   <input type="radio" name="location" value="shoppingMall">
821
                   <span>Shopping Mall</span>
822
                  </label>
823
                <label class="btn btn-default">
824
                    <input type="radio" name="location" value="MainMobileMarket">
825
                    <span>Main Mobile Market</span>
826
                </label>
827
                  <label class="btn btn-default">
828
                    <input type="radio" name="location" value="LocalMarket">
829
                    <span>Local Market</span>
830
                </label>
831
 
832
                </div>
833
 
834
 
835
 
836
             <h4 class="page-header">17.Nearest Mobile Store</h4>
837
                           <div class="btn-group">
838
                    <label class="btn btn-default">
839
                   <input type="radio" name="nearestStore" value="100mtrs">
840
                   <span>100Mtrs</span>
841
                  </label>
842
                <label class="btn btn-default">
843
                    <input type="radio" name="nearestStore" value="200mtrs">
844
                    <span>200Mtrs</span>
845
                </label>
846
                  <label class="btn btn-default">
847
                    <input type="radio" name="nearestStore" value="500mtrs">
848
                    <span>500Mtrs</span>
849
                </label>
850
 
851
                </div>
852
 
853
                 <div class="form-group location">
854
                   <label>Name of the Shop</label>
855
                       <input type="text" size ="35" name="storeName">
856
                       <br>
857
                       <br>
858
                        <label>Address of the Shop</label>
859
                       <input type="text" size ="65" name="storeAddress">
860
                  </div>
861
 
862
 
863
 
864
            <h4 class="page-header">18. Ownership of Shop</h4>
865
 
866
                    <div class="btn-group">
867
                    <label class="btn btn-default">
868
                   <input type="radio" name="ownership" value="Selfowned">
869
                   <span>Self Owned</span>
870
                  </label>
871
                <label class="btn btn-default">
872
                    <input type="radio" name="ownership" value="Rented">
873
                    <span>Rented</span>
874
                </label>
875
                  <label class="btn btn-default">
876
                    <input type="radio" name="ownership" value="lease">
877
                    <span>Lease</span>
878
                </label>
879
                  </label>
880
                  <label class="btn btn-default">
881
                    <input type="radio" name="ownership" value="collaboration">
882
                    <span>Collaboration</span>
883
                </label>
884
 
885
                </div>
886
 
887
                 <div class="form-group bdetail">
888
                   <p>Provide relevant documents (Electricity bill/Rent Agreement/Lease Deed)to prove the status of ownership</p>
889
                     <input type="file" accept="application/pdf,image/*" name="doc_ownershipDoc">
890
                     <input type="hidden" name="ownershipDoc"/>
891
                   </div>
892
 
893
 
894
           <h4 class="page-header">19. Insurance of Shop (if yes, please provide the copy of the same)</h4>
895
 
896
 
897
                    <div class="btn-group">
898
                    <label class="btn btn-default">
899
                   <input type="radio" name="insurance" value="yes">
900
                   <span>Yes</span>
901
                  </label>
902
                <label class="btn btn-default">
903
                    <input type="radio" name="insurance" value="no">
904
                    <span>No</span>
905
                </label>
906
              </div>
907
 
908
                 <div class="form-group insurance doc"  id= "docyes">
909
                  <p>Please provide copy of insurance document</p>
910
                     <input type="file" accept="application/pdf,image/*" name="doc_insuranceDoc">
911
                      <input type="hidden" name="insuranceDoc"/>
912
                   </div>
913
 
914
 
915
         <h4 class="page-header">20. Loan on Shop (LAP/BL/CC/others)</h4>
916
 
917
                     <div class="btn-group">
918
                    <label class="btn btn-default">
919
                   <input type="radio" name="loan" value="yes">
920
                   <span>Yes</span>
921
                  </label>
922
                <label class="btn btn-default">
923
                    <input type="radio" name="loan" value="no">
924
                    <span>No</span>
925
                </label>
926
              </div>
927
 
928
                 <div class="form-group loan document" id ="documentyes">
929
                  <p>Please provide current statement Letter</p>
930
                     <input type="file" accept="application/pdf,image/*" name="doc_loanDoc">
931
                     <input type="hidden" name="loanDoc"/>
932
                      <p>Please provide current sanction Letter</p>
933
                     <input type="file" accept="application/pdf,image/*" name="doc_sanctionDoc">
934
                     <input type="hidden" name="sanctionDoc"/>
935
                   </div>
936
 
937
 
938
            <h4 class="page-header">21. Bank Name & Address</h4>
939
 
940
                  <div class="form-group float-label-control">
941
                        <label for="">Account Number</label>
942
                        <input type="text" name="accountNumber"class="form-control" placeholder="Account Number">
943
                    </div>
944
                     <div class="form-group float-label-control">
945
                        <label for="">Bank Name</label>
946
                        <input type="text" name="bankName"class="form-control" placeholder="Bank Name">
947
                    </div>
948
                     <div class="form-group float-label-control">
949
                        <label for="">IFSC Code</label>
950
                        <input type="text" name="ifscCode"class="form-control" placeholder="IFSC Code">
951
                    </div>
952
                     <div class="form-group float-label-control">
953
                        <label for="">Branch Name</label>
954
                        <input type="text" name="branchName" class="form-control" placeholder="Branch Name">
955
                    </div>
956
                     <div >
957
                  <p>Please attach the copy of cancelled cheque</p>
958
                      <div class="form-group">
959
                     <input type="file" name="doc_chequeCopy" accept="application/pdf,image/*">
960
                     <input type="hidden" name="chequeCopy"/>
961
                   </div>
962
 
963
 
964
                  <h4 class="page-header">22. HSPS Bank Account Detail</h4> 
965
 
966
                  <p>Please deposit amount of <strong> Rs 1 Lac </strong>as advance payment in following account through NEFT and submit the UTR No.</p>
967
                    <div class="form-group float-label-control">
968
                        <label for="">UTR Number</label>
969
                        <input type="text" name="utr" class="form-control" placeholder="UTR No">
970
                    </div>
971
                    <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>
972
 
973
 
974
 
975
                      <div class ="Account">
976
                      <label>Account Name: New Spice Solutions Pvt Ltd</label><br>
977
                       <label>Bank Name: IndusInd Bank Ltd.</label><br>
978
                        <label>Account No.:201000488351</label><br>
979
                        <label>Branch:M-56, Greater Kailash-II, Main Market New Delhi-110048</label><br>
980
                         <label>IFSC:INDB0000012</label><br>
981
                        </div>
982
 
983
                <div class="submit">
984
                    <button type="submit" class="btn btn-success btn-lg">Submit</button>
985
                </div>
986
 
987
                <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>
988
 
989
 
990
 
991
 
992
 <!--             <fieldset hidden disabled="disabled">
993
              <h4 class="page-header">PMP STORE REGISTRATION APPROVAL</h4>
994
                 <p>(FOR OFFICE USE ONLY)</P>
995
 
996
                <div class=breg>
997
                 <div class=bApproval>
998
 
999
                  <label>Recommended by</label>
1000
                  <input type="text" name = "recommended"class="reg-control" size="50">
1001
 
1002
                  </div>
1003
                  <br>
1004
 
1005
                    <div class=bApproval>
1006
                  <label>Business Manager</label>
1007
                  <input type="text" name=" bManager" class="reg-control" size="50">
1008
                </div>
1009
                      <br>
1010
                        <div class=bApproval>
1011
                    <label>Operations Manager</label>
1012
                  <input type="text"name="operation"class="reg-control"  size="50">
1013
                </div>
1014
                  <br>
1015
               <div class=bApproval>
1016
                     <label>BusinessHeadCategoryHead</label>
1017
                  <input type="text" name="bhead"class="reg-control" size="50">
1018
                </div>
1019
 
1020
 
1021
                 </div>
1022
               </fieldset> -->
1023
 
1024
                      </form>
1025
                    </div>
1026
          </div>
1027
   <div class="col-sm-4">
1028
                <div class="panel panel-default">
1029
 
1030
                    <div class="panel-body">
1031
 
1032
 
1033
                   <label>Spice Global Knowledge Park - 6th Floor, Plot No.19A & 19B, Sector 125, Noida, UP - 201301</label>
1034
                   <br>
1035
                    <label>Email - care@profitmandi.com</<label>
1036
                    <br> 
1037
                    <label>Contact - 8588842949 </label>
1038
                    </div>
1039
                </div>
1040
            </div>
1041
 
1042
        </div>
1043
 
1044
    </div>
1045
    </div>
1046
</body>
1047
</html>