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22095 kshitij.so 1
<html>
2
<head>
3
 
22192 amit.gupta 4
<script src="${rc.contextPath}/resources/fofo-form/js/jquery-1.10.2.min.js"></script>
5
<link rel="stylesheet" href="${rc.contextPath}/resources/fofo-form/css/bootstrap.min.css"/>
6
<link rel="stylesheet" type="text/css" href="${rc.contextPath}/resources/fofo-form/css/main.css"/>
22095 kshitij.so 7
<!-- Optional theme -->
22192 amit.gupta 8
<link rel="stylesheet" href="${rc.contextPath}/resources/fofo-form/css/bootstrap-theme.min.css" />
22095 kshitij.so 9
 
10
<!-- Latest compiled and minified JavaScript -->
22192 amit.gupta 11
<script src="${rc.contextPath}/resources/fofo-form/js/bootstrap.min.js"></script>
12
<script src="${rc.contextPath}/resources/fofo-form/js/bootstrapValidator.js"></script>
13
<script src="${rc.contextPath}/resources/fofo-form/js/reg.js"></script>
14
<script src="${rc.contextPath}/resources/fofo-form/js/reqformvalidator.js"></script>
15
<script src="${rc.contextPath}/resources/fofo-form/js/fofoedit.js"></script>
16
<script src="${rc.contextPath}/resources/fofo-form/js/jquery.blockUI.js"></script>
22095 kshitij.so 17
<script type="text/javascript">
22155 amit.gupta 18
contexPath = "${rc.contextPath}";
22194 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,
22611 ashik.ali 116
	            crossDomain: true,
22095 kshitij.so 117
	           success: function (data) {
118
	           console.log(data);
119
	           	hiddenInput = inputName.split("_")[1];
120
	           	var doc_id = 0;
121
	           	if (data.response.document_id == 0){
122
	           		alert(data.response.message);
123
	           		return;
124
	           	}
125
	               $('input[name="' + hiddenInput + '"]').val(data.response.document_id);
22152 amit.gupta 126
	               validator.data('bootstrapValidator').revalidateField($('input[name="' + hiddenInput + '"]'));
22095 kshitij.so 127
	           }
128
	    });
129
	});
130
 
131
  });
132
});
133
 
134
function queryStringToJSON(queryString) {
135
  var pairs = queryString.split('&');
136
  var result = {};
137
  pairs.forEach(function(pair) {
138
    pair = pair.split('=');
139
    result[pair[0]] = decodeURIComponent(pair[1] || '');
140
 
141
  });
142
  return result;
143
}
144
 
22148 amit.gupta 145
/*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 146
 
147
function jQFormSerializeArrToJson(formSerializeArr){
148
 var jsonObj = {};
149
 jQuery.map( formSerializeArr, function( n, i ) {
150
     jsonObj[n.name] = n.value;
151
 });
152
 return jsonObj;
153
}
154
 
155
</script>
156
 
157
<style>
158
.loading-image {
159
position: fixed;
160
top: 50%;
161
left: 50%;
162
margin-top: -50px;
163
margin-left: -100px;
164
z-index: 100;
165
}
166
</style>
167
 
168
</head>
169
 
170
<body>
171
<div class="container">
172
    <div class="row">
173
         <div class ="header">   
174
		 <h3 class="header">HOTSPOT PARTNER STORE</h3>
175
         <h4 class="header">Powered by Profit Mandi (A Unit of Spice Group)</h4>
176
         </div>
177
 
178
        <div class="header">
179
            <h5 class="header">APPLICATION FOR REGISTRATION</h5>
180
       </div>  
181
        <hr />
182
 
183
        <div class="row">
184
            <div class="col-sm-8">
185
 
186
                <form role="form" name="myform" id ="form"  enctype="multipart/form-data"  data-toggle="validator" novalidate>
22195 amit.gupta 187
                <input type="hidden" name="_id" value="0"/>
22095 kshitij.so 188
             <h4 class="page-header">1. Registered Business Name of HSPS (in Block Letters)</h4>
189
                     <div class="form-group ">
190
 
191
                     <label for=""></label>
22534 ashik.ali 192
                     <input type="text" name="registeredBusinessName" id="demo" class="bform" placeholder="Business Name"  style="text-transform:uppercase;"/>
22095 kshitij.so 193
                     </div>
194
 
195
 
196
             <h4 class="page-header">2. Registered Address (In Block Letters)</h4>
197
 
198
                    <div class="form-group float-label-control">
199
                        <label for="">Line 1</label>
22534 ashik.ali 200
                        <input type="text" name ="line1" class="form-control" placeholder="Line 1" style="text-transform:uppercase;">
22095 kshitij.so 201
                    </div>
202
                     <div class="form-group float-label-control">
203
                        <label for="">Line 2</label>
22534 ashik.ali 204
                        <input type="text" name ="line2"class="form-control" placeholder="Line 2" style="text-transform:uppercase;">
22095 kshitij.so 205
                    </div>
206
                     <div class="form-group float-label-control">
207
                        <label for="">Line 3</label>
22534 ashik.ali 208
                        <input type="text" name="line3" class="form-control" placeholder="Line 3" style="text-transform:uppercase;">
22095 kshitij.so 209
                    </div>
210
                     <div class="form-group float-label-control">
211
                        <label for="">City</label>
22534 ashik.ali 212
                        <input type="text" name="city" class="form-control" placeholder="City" style="text-transform:uppercase;">
22095 kshitij.so 213
                    </div>
214
                      <div class="form-group float-label-control">
215
                        <label for="">District</label>
22534 ashik.ali 216
                        <input type="text" name="district" class="form-control" placeholder="District" style="text-transform:uppercase;">
22095 kshitij.so 217
                    </div>
218
                     <div class="form-group float-label-control">
219
                        <label for="">Pincode</label>
22534 ashik.ali 220
                        <input  type="text" name="pincode" maxlength="6" class="form-control" pattern="[0-9]{6}" title="Please enter correct Pin Code"placeholder="Pincode" style="text-transform:uppercase;">
22095 kshitij.so 221
                      </div>  
222
 
223
                     <div class="form-group float-label-control">
224
 
225
                      <select class="form-control" name = "state" placeholder="State">
226
                       <option value=" ">State</option>
227
                     <option value="Andaman and Nicobar Islands">Andaman and Nicobar Islands</option>
228
                            <option value="Andhra Pradesh">Andhra Pradesh</option>
229
                            <option value="Arunachal Pradesh">Arunachal Pradesh</option>
230
                            <option value="Assam">Assam</option>
231
                            <option value="Bihar">Bihar</option>
232
                            <option value="Chandigarh">Chandigarh</option>
233
                            <option value="Chhattisgarh">Chhattisgarh</option>
234
                            <option value="Dadra and Nagar Haveli">Dadra and Nagar Haveli</option>
235
                            <option value="Daman and Diu">Daman and Diu</option>
236
                            <option value="Delhi">Delhi</option>
237
                            <option value="Goa">Goa</option>
238
                            <option value="Gujarat">Gujarat</option>
239
                            <option value="Haryana">Haryana</option>
240
                            <option value="Himachal Pradesh">Himachal Pradesh</option>
241
                            <option value="Jammu and Kashmir">Jammu and Kashmir</option>
242
                            <option value="Jharkhand">Jharkhand</option>
243
                            <option value="Karnataka">Karnataka</option>
244
                            <option value="Kerala">Kerala</option>
245
                            <option value="Lakshadweep">Lakshadweep</option>
246
                            <option value="Madhya Pradesh">Madhya Pradesh</option>
247
                            <option value="Maharashtra">Maharashtra</option>
248
                            <option value="Manipur">Manipur</option>
249
                            <option value="Meghalaya">Meghalaya</option>
250
                            <option value="Mizoram">Mizoram</option>
251
                            <option value="Nagaland">Nagaland</option>
252
                            <option value="Orissa">Orissa</option>
253
                            <option value="Pondicherry">Pondicherry</option>
254
                            <option value="Punjab">Punjab</option>
255
                            <option value="Rajasthan">Rajasthan</option>
256
                            <option value="Sikkim">Sikkim</option>
257
                            <option value="Tamil Nadu">Tamil Nadu</option>
258
                            <option value="Tripura">Tripura</option>
259
                            <option value="Telangana">Telangana</option>
260
                            <option value="Uttaranchal">Uttaranchal</option>
261
                            <option value="Uttar Pradesh">Uttar Pradesh</option>
262
                            <option value="West Bengal">West Bengal</option>
263
                                              </select>
264
                    </div>
265
 
266
 
267
                      <div class="form-group float-label-control">
268
                        <label for="">Email1</label>
22534 ashik.ali 269
                        <input type="email" class="form-control" name="registeredEmail1" placeholder="Email1" readonly value="${email}" style="text-transform:uppercase;">
22095 kshitij.so 270
                      </div>  
271
                         <p>Example:- xyz<strong>.hsps@gmail.com</strong></p>
272
 
273
 
274
 
275
                        <div class="form-group float-label-control">
276
                        <label for="">Email2</label>
22534 ashik.ali 277
                        <input type="email" class="form-control" name="registeredEmail2" placeholder="Email2" style="text-transform:uppercase;">
22095 kshitij.so 278
                      </div> 
279
 
280
 
281
                       <div class="form-group float-label-control">
282
                        <label for="">Mobile</label>
22534 ashik.ali 283
                        <input  type="text" class="form-control" name="mobile" maxlength = "10" pattern="[0-9]{10}" title="Please enter valid Phone number" placeholder="Mobile" style="text-transform:uppercase;">
22095 kshitij.so 284
                      </div>  
285
 
286
                    <label>Landline</label>
287
                      <div class="form-group Pmpform">
22534 ashik.ali 288
                      <input type="text" name="stdcode" maxlength = "5" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="STDcode" style="text-transform:uppercase;"/> 
22095 kshitij.so 289
 
290
 
22534 ashik.ali 291
                      <input type="text" name="telephone" maxlength = "10" pattern="[0-9]*" title="Please enter valid Phone number" placeholder="Telephone" style="text-transform:uppercase;"/>
22095 kshitij.so 292
                      </div>
293
 
294
 
295
 
296
             <h4 class="page-header">3. Type of Business Entity</h4>
297
 
298
                   <div class="funkyradio">
299
 
300
                    <div class="funkyradio-primary">
301
                        <input type="radio" name="bEntity" id="radio1" value="SaleProprietorship" required>
302
                        <label for="radio1">Proprietor</label>
303
                    </div>
304
                    <div class="funkyradio-primary">
305
                        <input type="radio" name="bEntity" id="radio2" value="Partnership" required>
306
                        <label for="radio2">Partnership</label>
307
                    </div>
308
                    <div class="funkyradio-primary">
309
                        <input type="radio" name="bEntity" id="radio3" value="PrivateLimitedCompany" required>
310
                        <label for="radio3">Private Limited company</label>
311
                    </div>
312
                    <div class="funkyradio-primary">
313
                        <input type="radio" name="bEntity" id="radio4" value="LimitedLiabilityPartnership" required>
314
                        <label for="radio4">Limited Liability Partnership</label>
315
                    </div>
316
                </div>
317
                  <div class ="Entity">
318
                    <div class="SaleProprietorship box" id ="saleSaleProprietorship">Upload <strong>Proprietership proof</strong></div>
319
                     <div class="partnership box" id="salePartnership">Upload <strong>Partnership Deed</strong></div>
320
                     </div>
321
                      <div class="limitedcompany box" id="salePrivateLimitedCompany">
322
                      <div class="form-group float-label-control">
323
                        <label for="">DIN Number</label>
22534 ashik.ali 324
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number" style="text-transform:uppercase;">
22095 kshitij.so 325
                    </div>Upload <strong>Incorporation certificate,Memorandum & Article of association</strong>
326
                      </div>
327
 
328
 
329
                      <div class="LimitedLiabilityPartnership box" id="saleLimitedLiabilityPartnership">
330
 
331
 
332
                           <div class="form-group float-label-control">
333
                        <label for="">DIN Number</label>
22534 ashik.ali 334
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number" style="text-transform:uppercase;">
22095 kshitij.so 335
                    </div>Upload <strong>Registration certificate & partnership Deed</strong>
336
                     </div>
337
 
338
                    <div class = "form-group file upload"> 
339
                   <input type="file" accept="application/pdf,image/*" id="doc" name ="doc_bEntityDoc">
340
 
341
                   <input type="hidden" name="bEntityDoc"/>
342
                    </div>
343
 
344
                     <h4 class="page-header">4. Goods And Services Tax Number(GST)</h4>
345
                    <div class="Pmpform">
346
 
347
                        <input type="text" name="gst" class="bform" placeholder="Goods And Services Tax Number"/>
348
                    </div>
349
                     <p>Provide Copy of GST document</p>
350
                    <div class = "file upload"> 
351
                   <input type="file"  accept="application/pdf,image/*" name ="doc_gstDoc">
352
                     <input type="hidden" name="gstDoc"/>
353
                    </div>
354
 
355
 
356
                     <h4 class="page-header">5. Permanent Account Number(PAN)</h4>
357
                    <div class="form-group ">
358
 
359
                     <label for=""></label>
22534 ashik.ali 360
                     <input type="text" name="pan" maxlength="10" class="bform" placeholder="Permanent Account Number" style="text-transform:uppercase;"/></div>
22095 kshitij.so 361
                     <p>Provide Copy of PAN </p>
362
 
363
                    <div class = "form-group file upload"> 
364
 
365
                   <input type="file" accept="application/pdf,image/*" name="doc_panDoc">
366
                     <input type="hidden" name="panDoc"/>
367
                    </div>
368
 
369
 
370
             <h4 class="page-header">6. Full Details Of Business Entity</h4>
371
 
372
                   <div class="funkyradio">
373
                    <div class="funkyradio-primary">
374
                        <input type="radio" name="bPmpDetail" id="business1" value="Proprietor" required>
375
                        <label for="business1">Proprietor</label>
376
                    </div>
377
                    <div class="funkyradio-primary">
378
                        <input type="radio" name="bPmpDetail" id="business2" value="Partners" required>
379
                        <label for="business2">Partners</label>
380
                    </div>
381
                    <div class="funkyradio-primary">
382
                        <input type="radio" name="bPmpDetail" id="business3" value="Directors" required>
383
                        <label for="business3">Directors</label>
384
                    </div>
385
                </div>
386
 
387
                <div class="tablecontainer">
388
   <table class="businessdetail">
389
              <tr> 
390
              <th class ="PMPName">Name</th>
391
              <th  class="PMPAddress">Address</th> 
392
              <th class="PMPtelno">Mobile</th>
393
              <th class="PMPpan">PAN</th>
394
              <th class="PMPAdhaar">Aadhaar Number</th>
395
              <th class="PMPemail">Email</th>
396
              <th class="PMPownership">Share %</th>
397
 
398
               </tr>
399
            <tr>
400
 
22534 ashik.ali 401
                   <td class="form-group"><input type="text" name="proprietorBusineesName"size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 402
                   <td class="form-group"><textarea row="3" name="proprietorAddress"></textarea></td>
22534 ashik.ali 403
                   <td class="form-group"><input type="text" name="proprietorPhone" maxlength="10" pattern="[0-9]{10}"size="10" style="text-transform:uppercase;"></th>
404
                   <td class="form-group"><input type="text" name="proprietorPan" maxlength="10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
405
                    <td class="form-group"><input type="text"  name= "proprietorAdhaar" size="15" style="text-transform:uppercase;"></td>
406
                   <td class="form-group"><input type="email"  name= "proprietorEmail" size="20" style="text-transform:uppercase;"></td>
407
                   <td class="form-group"><input type="text" pattern="[0-9]" name="proprietorOwner" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 408
 
409
                   </tr>
410
 
411
 
412
            </table>
413
 
414
            </div>
415
            <div class="Partners pmp" id= "PmpPartners">
416
            <table class="businessdetail">
417
 
418
             <tr> 
419
              <th class ="PMPName">Name</th>
420
              <th  class="PMPAddress">Address</th> 
421
              <th class="PMPtelno">Mobile</th>
422
              <th class="PMPpan">PAN</th>
423
              <th class="PMPAdhaar">Aadhaar Number</th>
424
              <th class="PMPemail">Email</th>
425
              <th class="PMPownership">Share %</th>
426
 
427
               </tr>
428
                <tr>
429
 
22534 ashik.ali 430
                   <td class="form-group"><input name="partnerName1"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 431
                   <td class="form-group"><textarea name="partnerAddress1" type="text" size="60"></textarea></td>
22534 ashik.ali 432
                   <td class="form-group"><input name = "partnerPhone1" pattern="[0-9]{10}"type="text" size="10" style="text-transform:uppercase;"></th>
433
                   <td class="form-group"><input  name ="partnerPan1"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
434
                    <td class="form-group"><input name="partnerAdhaar1" type="text"  size="15" style="text-transform:uppercase;"></td>
435
                   <td class="form-group"><input name="partnerEmail1" type="email"  size="20" style="text-transform:uppercase;"></td>
436
                   <td class="form-group"><input name="partnerOwner1" type="text"pattern="[0-9]"size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 437
 
438
                   </tr>
439
 
440
 
441
            </table>
442
 
443
                   <table class="businessdetail">
444
 
445
             <tr> 
446
              <th class ="PMPName">Name</th>
447
              <th  class="PMPAddress">Address</th> 
448
              <th class="PMPtelno">Mobile</th>
449
              <th class="PMPpan">PAN</th>
450
              <th class="PMPAdhaar">Aadhaar Number</th>
451
              <th class="PMPemail">Email</th>
452
              <th class="PMPownership">Share %</th>
453
 
454
               </tr>
455
              <tr>
456
 
22534 ashik.ali 457
                   <td class="form-group"><input name="partnerName2"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 458
                   <td class="form-group"><textarea name="partnerAddress2" type="text" size="60"></textarea></td>
22534 ashik.ali 459
                   <td class="form-group"><input name = "partnerPhone2" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
460
                   <td class="businesspan"><input  name ="partnerPan2"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
461
                   <td class="form-group"><input name="partnerAdhaar2" type="text" size="15" style="text-transform:uppercase;"></td>
462
                   <td class="form-group"><input name="partnerEmail2" type="email" size="20" style="text-transform:uppercase;"></td>
463
                   <td class="form-group"><input name="partnerOwner2" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 464
 
465
                   </tr>
466
 
467
            </table>
468
                   <table class="businessdetail">
469
             <tr> 
470
            <th class ="PMPName">Name</th>
471
              <th  class="PMPAddress">Address</th> 
472
              <th class="PMPtelno">Mobile</th>
473
              <th class="PMPpan">PAN</th>
474
              <th class="PMPAdhaar">Aadhaar Number</th>
475
              <th class="PMPemail">Email</th>
476
              <th class="PMPownership">Share %</th>
477
 
478
               </tr>
479
                 <tr>
480
 
22534 ashik.ali 481
                   <td class="form-group"><input name="partnerName3"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 482
                   <td class="form-group"><textarea name="partnerAddress3" type="text" size="60"></textarea></td>
22534 ashik.ali 483
                   <td class="form-group"><input name = "partnerPhone3" type="text"  maxlength = "10" pattern="[0-9]{10}"  size="10" style="text-transform:uppercase;"></th>
484
                   <td class="form-group"><input  name ="partnerPan3"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
485
                    <td class="form-group"><input name="partnerAdhaar3" type="text" size="15" style="text-transform:uppercase;"></td>
486
                   <td class="form-group"><input name="partnerEmail3"  type="email" size="20" style="text-transform:uppercase;"></td>
487
                   <td class="form-group"><input name="partnerOwner3" pattern="[0-9"  type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 488
 
489
                   </tr>
490
 
491
 
492
            </table>
493
 
494
 
495
 
496
           <table class="businessdetail">
497
       <tr> 
498
                <th class ="PMPName">Name</th>
499
              <th  class="PMPAddress">Address</th> 
500
              <th class="PMPtelno">Mobile</th>
501
              <th class="PMPpan">PAN</th>
502
              <th class="PMPAdhaar">Aadhaar Number</th>
503
              <th class="PMPemail">Email</th>
504
              <th class="PMPownership">Share %</th>
505
               </tr>
506
               <tr>
507
 
22534 ashik.ali 508
                   <td class="form-group"><input name="partnerName4"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 509
                   <td class="form-group"><textarea name="partnerAddress4" type="text" size="60"></textarea></td>
22534 ashik.ali 510
                   <td class="form-group"><input name = "partnerPhone4"  pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
511
                   <td class="form-group"><input  name ="partnerPan4"type="text" maxlength = "10"title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
512
                    <td class="form-group"><input name="partnerAdhaar4" type="text" size="15" style="text-transform:uppercase;"></td>
513
                   <td class="form-group"><input name="partnerEmail4" type="email" size="20" style="text-transform:uppercase;"></td>
514
                   <td class="form-group"><input name="partnerOwner4" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 515
 
516
                   </tr>
517
 
518
 
519
            </table>
520
 
521
            </div>
522
 
523
 
524
             <div class="Directors pmp" id= "PmpDirectors">
525
            <table class="businessdetail">
526
               <tr> 
527
               <th class ="PMPName">Name</th>
528
              <th  class="PMPAddress">Address</th> 
529
              <th class="PMPtelno">Mobile</th>
530
              <th class="PMPpan">PAN</th>
531
              <th class="PMPAdhaar">Aadhaar Number</th>
532
              <th class="PMPemail">Email</th>
533
              <th class="PMPownership">Share %</th>
534
 
535
               </tr>
536
               <tr>
22534 ashik.ali 537
                   <td class="form-group"><input name="shareholderName1"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 538
                   <td class="form-group"><textarea name="shareholderAddress1" type="text" size="60"></textarea></td>
22534 ashik.ali 539
                   <td class="form-group"><input name = "shareholderPhone1" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
540
                   <td class="form-group"><input  name ="shareholderPan1"type="text" maxlength = "10"  title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
541
                   <td class="form-group"><input name="shareholderAdhaar1" type="text" size="15" style="text-transform:uppercase;"></td>
542
                   <td class="form-group"><input name="shareholderEmail1" type="email" size="20" style="text-transform:uppercase;"></td>
543
                   <td class="form-group"><input name="shareholderOwner1" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 544
 
545
                   </tr>
546
 
547
 
548
            </table>
549
 
550
                   <table class="businessdetail">
551
          <tr> 
552
                <th class ="PMPName">Name</th>
553
              <th  class="PMPAddress">Address</th> 
554
              <th class="PMPtelno">Mobile</th>
555
              <th class="PMPpan">PAN</th>
556
              <th class="PMPAdhaar">Aadhaar Number</th>
557
              <th class="PMPemail">Email</th>
558
              <th class="PMPownership">Share %</th>
559
               </tr>
560
                 <tr>
22534 ashik.ali 561
                   <td class="form-group"><input name="shareholderName2"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 562
                   <td class="form-group"><textarea name="shareholderAddress2" type="text" size="60"></textarea></td>
22534 ashik.ali 563
                   <td class="form-group"><input name = "shareholderPhone2" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
564
                   <td class="form-group"><input  name ="shareholderPan2"type="text" maxlength = "10"  title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
565
                    <td class="form-group"><input name="shareholderAdhaar2" type="text" size="15" style="text-transform:uppercase;"></td>
566
                   <td class="form-group"><input name="shareholderEmail2"  type="email" size="20" style="text-transform:uppercase;"></td>
567
                   <td class="form-group"><input name="shareholderOwner2" pattern="[0-9]"  type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 568
 
569
                   </tr>
570
            </table>
571
 
572
                   <table class="businessdetail">
573
              <tr> 
574
                <th class ="PMPName">Name</th>
575
              <th  class="PMPAddress">Address</th> 
576
              <th class="PMPtelno">Mobile</th>
577
              <th class="PMPpan">PAN</th>
578
              <th class="PMPAdhaar">Aadhaar Number</th>
579
              <th class="PMPemail">Email</th>
580
              <th class="PMPownership">Share %</th>
581
 
582
               </tr>
583
                   <tr>
22534 ashik.ali 584
                   <td class="form-group"><input name="shareholderName3"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 585
                   <td class="form-group"><textarea name="shareholderAddress3" type="text" size="60"></textarea></td>
22534 ashik.ali 586
                   <td class="form-group"><input name = "shareholderPhone3" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
587
                   <td class="form-group"><input  name ="shareholderPan3" type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
588
                   <td class="form-group"><input name="shareholderAdhaar3" type="text" size="15" style="text-transform:uppercase;"></td>
589
                   <td class="form-group"><input name="shareholderEmail3" type="email" size="20" style="text-transform:uppercase;"></td>
590
                   <td class="form-group"><input name="shareholderOwner3" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 591
 
592
                   </tr>
593
 
594
            </table>
595
 
596
                   <table class="businessdetail">
597
             <tr> 
598
                <th class ="PMPName">Name</th>
599
              <th  class="PMPAddress">Address</th> 
600
              <th class="PMPtelno">Mobile</th>
601
              <th class="PMPpan">PAN</th>
602
              <th class="PMPAdhaar">Aadhaar Number</th>
603
              <th class="PMPemail">Email</th>
604
              <th class="PMPownership">Share %</th>
605
               </tr>
606
                     <tr>
22534 ashik.ali 607
                   <td class="form-group"><input name="shareholderName4" type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 608
                   <td class="form-group"><textarea name="shareholderAddress4" type="text" size="60"></textarea></td>
22534 ashik.ali 609
                   <td class="form-group"><input name = "shareholderPhone4" type="text" pattern="[0-9]{10}" size="10" style="text-transform:uppercase;"></th>
610
                   <td class="form-group"><input  name ="shareholderPan4" type="text" maxlength = "10"  title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
611
                    <td class="form-group"><input name="shareholderAdhaar4" type="text" size="15" style="text-transform:uppercase;"></td>
612
                   <td class="form-group"><input name="shareholderEmail4"  type="email" size="20" style="text-transform:uppercase;"></td>
613
                   <td class="form-group"><input name="shareholderOwner4" pattern="[0-9]"  type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 614
 
615
                   </tr>
616
 
617
 
618
            </table>
619
 
620
            </div>
621
 
622
         <h4 class="page-header">7. Store Manager Details</h4>
623
 
624
 
625
                    <div class="form-group">
626
                    <label for="">Name
627
                    <input type="text" name="managerName"placeholder="Name"></label>
628
                    <label for="">Mobile
22534 ashik.ali 629
                        <input type="text" name="managerNo" pattern="[0-9]{10}" title="Please enter Valid Mobile number" placeholder="Mobile No" style="text-transform:uppercase;"> </label>  
22095 kshitij.so 630
                    <label for="">Email
22534 ashik.ali 631
                        <input type="email" name="managerEmail"size="25px" placeholder="Emailid" style="text-transform:uppercase;"> </label>  
22095 kshitij.so 632
 
633
                    </div>
634
 
635
 
636
            <h4 class="page-header">8. Manpower Details</h4>
637
 
638
               <div class="form-group">
639
                    <label for="">Number of Employees
22534 ashik.ali 640
                    <input type="text" pattern="[0-9]" name="noOfEmployees"placeholder="Number of Employees" style="text-transform:uppercase;"></label>
22095 kshitij.so 641
                    <label for="">Number of Management Staff
22534 ashik.ali 642
                        <input type="text" pattern="[0-9]" name="managementStaff" placeholder="Management Staff" style="text-transform:uppercase;"> </label>  
22095 kshitij.so 643
 
644
                    </div>
645
 
646
              <h4 class="page-header">9. Experience In Telecom Trade/other Trade (Brand & Product Category)</h4>
647
                <div class="bcontacts">
648
                   <textarea rows="4" name="experienceinTelecome"cols="50" placeholder="Describe yourself here..."></textarea> 
649
                </div>
650
 
651
            <h4 class="page-header">10. Description of Existing Business & Annual Turnover</h4>
652
                <div class="bcontacts">
653
                      <textarea rows="4" name="descriptionofExistingBusiness"cols="50" placeholder="Describe yourself here..."></textarea>
654
                </div>
655
                <p>Please Provide ITR of last Two years</p>
656
                <div class = "form-group file upload"> 
657
                   <input type="file" accept="application/pdf,image/*" name ="doc_itrDoc">
658
                      <input type="hidden" name="itrDoc"/>
659
                    </div>
660
 
661
 
662
            <h4 class="page-header">11.Business Model</h4>
663
 
664
            <div class="btn-group">
665
                    <label class="btn btn-default">
666
                   <input type="radio" name="businessModel" value="Retailer" required>
667
                   <span>Retailer</span>
668
                  </label>
669
                <label class="btn btn-default">
670
                    <input type="radio" name="businessModel" value="Distributor" required>
671
                    <span>Distributor</span>
672
                </label>
673
                <label class="btn btn-default">
674
                    <input type="radio" name="businessModel" value="Franchises" required>
675
                    <span>Franchise</span>
676
                </label>
677
                  <label class="btn btn-default">
678
                    <input type="radio" name="businessModel" value="Other" required>
679
                    <span>Other</span>
680
                </label>
681
              </div>
682
 
683
 
684
          <h4 class="page-header">12. Selling Online (if yes, please specify Portal Names)</h4>
685
 
686
                    <div class="btn-group">
687
                    <label class="btn btn-default">
688
                   <input type="radio" name="sellingOnline" value="yes">
689
                   <span>Yes</span>
690
                  </label>
691
                <label class="btn btn-default">
692
                    <input type="radio" name="sellingOnline" value="no">
693
                    <span>No</span>
694
                </label>
695
              </div>
696
                   <div class="form-group portal Names" id = "sellingyes">
697
                   <label>Portal Names</label>
22534 ashik.ali 698
                       <input type="text" name="portalName1" size="25" style="text-transform:uppercase;">
699
                       <input type="text" name="portalName2" size="25" style="text-transform:uppercase;">
700
                       <input type="text" name="portalName3" size="25" style="text-transform:uppercase;">
22095 kshitij.so 701
                  </div>
702
            <h4 class="page-header">13. Area of Shop(in Sq Feet)</h4>
703
              <div>
704
                 <div class="form-group">
705
                    <label>
706
 
707
                    <input type="number" name="east"  placeholder="East(Sq Feet)">
708
                    <input type="number" name="west"  placeholder="West(Sq Feet)">
709
                    <input type="number" name="north" placeholder="North(Sq Feet)"> 
710
                    </label>
711
                </div>
712
                    <br>
713
                      <div class="form-group">
714
                    <label>
715
 
716
                    <input type="number" name="south" placeholder="South(Sq Feet)">
717
                    <input type="number" name="front" placeholder="Front(Sq Feet)">
718
                    <input type="number" name="roadSize" placeholder="Road Size in Front(Sq Feet)">
719
 
720
                    </label>
721
                </div>
722
 
723
                  </div>  
724
                  <div class="shopArea">
725
                   <div class="btn-group">
726
                    <label class="btn btn-default">
727
                   <input type="radio" name="shopArea" value="Singleside">
728
                   <span>Single Side</span>
729
                  </label>
730
                <label class="btn btn-default">
731
                    <input type="radio" name="shopArea" value"Twoside">
732
                    <span>Two Side</span>
733
                </label>
734
                  <label class="btn btn-default">
735
                    <input type="radio" name="shopArea" value="Corner">
736
                    <span>Corner</span>
737
                </label>
738
              </div>
739
              </div>
740
 
741
 
742
              <h4 class="page-header">14. Status of Shop</h4>
743
 
744
                 <div class="btn-group">
745
                    <label class="btn btn-default">
746
                   <input type="radio" name="shopStatus" value="semifurnished">
747
                   <span>Semi Furnished</span>
748
                  </label>
749
                <label class="btn btn-default">
750
                    <input type="radio" name="shopStatus" value="fullfurnished">
751
                    <span>Fully Furnished</span>
752
                </label>
753
                </div>
754
 
755
                 <div class="checkboxes status" id ="shopsemifurnished">
756
                 <div class="btn btn-default">
757
   <label for="success1" class="btn btn-success">Flooring<input type="checkbox" name="flooring" 
758
          value ="flooring" id="success1" class="badgebox"><span class="badge">&check;</span></label>
759
        <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>
760
 
761
 
762
              </div>
763
            </div>
764
 
765
<div class ="checkboxes status"  id ="shopfullfurnished">
766
          <div class="row text-center">
767
    <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>
768
        <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>
769
        <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>
770
        <label for="success" class="btn btn-success">Electricity<input type="checkbox" name="electricity" 
771
          value ="yes" id="success" class="badgebox"><span class="badge">&check;</span></label>
772
        <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>
773
  </div>
774
    </div>
775
 
776
 
777
              <h4 class="page-header">15. Shop Available At</h4>
778
 
779
                     <div class="btn-group">
780
                    <label class="btn btn-default">
781
                   <input type="radio" name="shopAvailbility" value="Basement">
782
                   <span>Basement</span>
783
                  </label>
784
                <label class="btn btn-default">
785
                    <input type="radio" name="shopAvailbility" value="Groundfloor">
786
                    <span>Ground Floor</span>
787
                </label>
788
                  <label class="btn btn-default">
789
                    <input type="radio" name="shopAvailbility" value="firstfloor">
790
                    <span>First Floor</span>
791
                </label>
792
 
793
                  <label class="btn btn-default">
794
                    <input type="radio" name="shopAvailbility" value="secondfloor">
795
                    <span>Second Floor</span>
796
                </label>
797
 
798
                 <label class="btn btn-default">
799
                    <input type="radio" name="shopAvailbility" value="thirdfloor">
800
                    <span>Third Floor</span>
801
                </label>
802
                </div>
803
 
804
                <div class="form-group bdetail">
805
                   <p>Provide pictures of the shop from 3 different angles, ceiling and flooring</p>
806
                      <input type="file" name="doc_angleDoc1" accept="application/pdf,image/*" >
807
                      <input type="hidden" name="angleDoc1"/>
808
                      <input type="file" name="doc_angleDoc2" accept="application/pdf,image/*" >
809
                      <input type="hidden" name="angleDoc2"/>
810
                      <input type="file" name="doc_angleDoc3"  accept="application/pdf,image/*" >
811
                      <input type="hidden" name="angleDoc3"/>
812
                      <input type="file" name="doc_angleDoc4"  accept="application/pdf,image/*" >
813
                      <input type="hidden" name="angleDoc4"/>
814
                      <input type="file" name="doc_angleDoc5" accept="application/pdf,image/*">
815
                      <input type="hidden" name="angleDoc5"/>
816
                  </div>
817
 
818
         <h4 class="page-header">16. Location of Shop</h4>
819
                        <div class="btn-group">
820
                    <label class="btn btn-default">
821
                   <input type="radio" name="location" value="shoppingMall">
822
                   <span>Shopping Mall</span>
823
                  </label>
824
                <label class="btn btn-default">
825
                    <input type="radio" name="location" value="MainMobileMarket">
826
                    <span>Main Mobile Market</span>
827
                </label>
828
                  <label class="btn btn-default">
829
                    <input type="radio" name="location" value="LocalMarket">
830
                    <span>Local Market</span>
831
                </label>
832
 
833
                </div>
834
 
835
 
836
 
837
             <h4 class="page-header">17.Nearest Mobile Store</h4>
838
                           <div class="btn-group">
839
                    <label class="btn btn-default">
840
                   <input type="radio" name="nearestStore" value="100mtrs">
841
                   <span>100Mtrs</span>
842
                  </label>
843
                <label class="btn btn-default">
844
                    <input type="radio" name="nearestStore" value="200mtrs">
845
                    <span>200Mtrs</span>
846
                </label>
847
                  <label class="btn btn-default">
848
                    <input type="radio" name="nearestStore" value="500mtrs">
849
                    <span>500Mtrs</span>
850
                </label>
851
 
852
                </div>
853
 
854
                 <div class="form-group location">
855
                   <label>Name of the Shop</label>
22534 ashik.ali 856
                       <input type="text" size ="35" name="storeName" style="text-transform:uppercase;">
22095 kshitij.so 857
                       <br>
858
                       <br>
859
                        <label>Address of the Shop</label>
22534 ashik.ali 860
                       <input type="text" size ="65" name="storeAddress" style="text-transform:uppercase;">
22095 kshitij.so 861
                  </div>
862
 
863
 
864
 
865
            <h4 class="page-header">18. Ownership of Shop</h4>
866
 
867
                    <div class="btn-group">
868
                    <label class="btn btn-default">
869
                   <input type="radio" name="ownership" value="Selfowned">
870
                   <span>Self Owned</span>
871
                  </label>
872
                <label class="btn btn-default">
873
                    <input type="radio" name="ownership" value="Rented">
874
                    <span>Rented</span>
875
                </label>
876
                  <label class="btn btn-default">
877
                    <input type="radio" name="ownership" value="lease">
878
                    <span>Lease</span>
879
                </label>
880
                  </label>
881
                  <label class="btn btn-default">
882
                    <input type="radio" name="ownership" value="collaboration">
883
                    <span>Collaboration</span>
884
                </label>
885
 
886
                </div>
887
 
888
                 <div class="form-group bdetail">
889
                   <p>Provide relevant documents (Electricity bill/Rent Agreement/Lease Deed)to prove the status of ownership</p>
890
                     <input type="file" accept="application/pdf,image/*" name="doc_ownershipDoc">
891
                     <input type="hidden" name="ownershipDoc"/>
892
                   </div>
893
 
894
 
895
           <h4 class="page-header">19. Insurance of Shop (if yes, please provide the copy of the same)</h4>
896
 
897
 
898
                    <div class="btn-group">
899
                    <label class="btn btn-default">
900
                   <input type="radio" name="insurance" value="yes">
901
                   <span>Yes</span>
902
                  </label>
903
                <label class="btn btn-default">
904
                    <input type="radio" name="insurance" value="no">
905
                    <span>No</span>
906
                </label>
907
              </div>
908
 
909
                 <div class="form-group insurance doc"  id= "docyes">
910
                  <p>Please provide copy of insurance document</p>
911
                     <input type="file" accept="application/pdf,image/*" name="doc_insuranceDoc">
912
                      <input type="hidden" name="insuranceDoc"/>
913
                   </div>
914
 
915
 
916
         <h4 class="page-header">20. Loan on Shop (LAP/BL/CC/others)</h4>
917
 
918
                     <div class="btn-group">
919
                    <label class="btn btn-default">
920
                   <input type="radio" name="loan" value="yes">
921
                   <span>Yes</span>
922
                  </label>
923
                <label class="btn btn-default">
924
                    <input type="radio" name="loan" value="no">
925
                    <span>No</span>
926
                </label>
927
              </div>
928
 
929
                 <div class="form-group loan document" id ="documentyes">
930
                  <p>Please provide current statement Letter</p>
931
                     <input type="file" accept="application/pdf,image/*" name="doc_loanDoc">
932
                     <input type="hidden" name="loanDoc"/>
933
                      <p>Please provide current sanction Letter</p>
934
                     <input type="file" accept="application/pdf,image/*" name="doc_sanctionDoc">
935
                     <input type="hidden" name="sanctionDoc"/>
936
                   </div>
937
 
938
 
939
            <h4 class="page-header">21. Bank Name & Address</h4>
940
 
941
                  <div class="form-group float-label-control">
942
                        <label for="">Account Number</label>
22534 ashik.ali 943
                        <input type="text" name="accountNumber"class="form-control" placeholder="Account Number" style="text-transform:uppercase;">
22095 kshitij.so 944
                    </div>
945
                     <div class="form-group float-label-control">
946
                        <label for="">Bank Name</label>
22534 ashik.ali 947
                        <input type="text" name="bankName"class="form-control" placeholder="Bank Name" style="text-transform:uppercase;">
22095 kshitij.so 948
                    </div>
949
                     <div class="form-group float-label-control">
950
                        <label for="">IFSC Code</label>
22534 ashik.ali 951
                        <input type="text" name="ifscCode"class="form-control" placeholder="IFSC Code" style="text-transform:uppercase;">
22095 kshitij.so 952
                    </div>
953
                     <div class="form-group float-label-control">
954
                        <label for="">Branch Name</label>
22534 ashik.ali 955
                        <input type="text" name="branchName" class="form-control" placeholder="Branch Name" style="text-transform:uppercase;">
22095 kshitij.so 956
                    </div>
957
                     <div >
958
                  <p>Please attach the copy of cancelled cheque</p>
959
                      <div class="form-group">
960
                     <input type="file" name="doc_chequeCopy" accept="application/pdf,image/*">
961
                     <input type="hidden" name="chequeCopy"/>
962
                   </div>
963
 
964
 
965
                  <h4 class="page-header">22. HSPS Bank Account Detail</h4> 
966
 
967
                  <p>Please deposit amount of <strong> Rs 1 Lac </strong>as advance payment in following account through NEFT and submit the UTR No.</p>
968
                    <div class="form-group float-label-control">
969
                        <label for="">UTR Number</label>
22534 ashik.ali 970
                        <input type="text" name="utr" class="form-control" placeholder="UTR No" style="text-transform:uppercase;">
22095 kshitij.so 971
                    </div>
972
                    <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>
973
 
974
 
975
 
976
                      <div class ="Account">
977
                      <label>Account Name: New Spice Solutions Pvt Ltd</label><br>
978
                       <label>Bank Name: IndusInd Bank Ltd.</label><br>
979
                        <label>Account No.:201000488351</label><br>
980
                        <label>Branch:M-56, Greater Kailash-II, Main Market New Delhi-110048</label><br>
981
                         <label>IFSC:INDB0000012</label><br>
982
                        </div>
983
 
984
                <div class="submit">
985
                    <button type="submit" class="btn btn-success btn-lg">Submit</button>
986
                </div>
987
 
988
                <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>
989
 
990
 
991
 
992
 
993
 <!--             <fieldset hidden disabled="disabled">
994
              <h4 class="page-header">PMP STORE REGISTRATION APPROVAL</h4>
995
                 <p>(FOR OFFICE USE ONLY)</P>
996
 
997
                <div class=breg>
998
                 <div class=bApproval>
999
 
1000
                  <label>Recommended by</label>
22534 ashik.ali 1001
                  <input type="text" name = "recommended"class="reg-control" size="50" style="text-transform:uppercase;">
22095 kshitij.so 1002
 
1003
                  </div>
1004
                  <br>
1005
 
1006
                    <div class=bApproval>
1007
                  <label>Business Manager</label>
22534 ashik.ali 1008
                  <input type="text" name=" bManager" class="reg-control" size="50" style="text-transform:uppercase;">
22095 kshitij.so 1009
                </div>
1010
                      <br>
1011
                        <div class=bApproval>
1012
                    <label>Operations Manager</label>
22534 ashik.ali 1013
                  <input type="text"name="operation"class="reg-control"  size="50" style="text-transform:uppercase;">
22095 kshitij.so 1014
                </div>
1015
                  <br>
1016
               <div class=bApproval>
1017
                     <label>BusinessHeadCategoryHead</label>
22534 ashik.ali 1018
                  <input type="text" name="bhead"class="reg-control" size="50" style="text-transform:uppercase;">
22095 kshitij.so 1019
                </div>
1020
 
1021
 
1022
                 </div>
1023
               </fieldset> -->
1024
 
1025
                      </form>
1026
                    </div>
1027
          </div>
1028
   <div class="col-sm-4">
1029
                <div class="panel panel-default">
1030
 
1031
                    <div class="panel-body">
1032
 
1033
 
1034
                   <label>Spice Global Knowledge Park - 6th Floor, Plot No.19A & 19B, Sector 125, Noida, UP - 201301</label>
1035
                   <br>
1036
                    <label>Email - care@profitmandi.com</<label>
1037
                    <br> 
1038
                    <label>Contact - 8588842949 </label>
1039
                    </div>
1040
                </div>
1041
            </div>
1042
 
1043
        </div>
1044
 
1045
    </div>
1046
    </div>
1047
</body>
1048
</html>