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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',
22614 ashik.ali 111
	          headers: {
112
                    'Access-Control-Allow-Origin': '*'
113
                },
22095 kshitij.so 114
	          data: formData,
115
	          	cache: false,
116
            contentType: false,
117
            processData: false,
118
	           success: function (data) {
119
	           console.log(data);
120
	           	hiddenInput = inputName.split("_")[1];
121
	           	var doc_id = 0;
122
	           	if (data.response.document_id == 0){
123
	           		alert(data.response.message);
124
	           		return;
125
	           	}
126
	               $('input[name="' + hiddenInput + '"]').val(data.response.document_id);
22152 amit.gupta 127
	               validator.data('bootstrapValidator').revalidateField($('input[name="' + hiddenInput + '"]'));
22095 kshitij.so 128
	           }
129
	    });
130
	});
131
 
132
  });
133
});
134
 
135
function queryStringToJSON(queryString) {
136
  var pairs = queryString.split('&');
137
  var result = {};
138
  pairs.forEach(function(pair) {
139
    pair = pair.split('=');
140
    result[pair[0]] = decodeURIComponent(pair[1] || '');
141
 
142
  });
143
  return result;
144
}
145
 
22148 amit.gupta 146
/*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 147
 
148
function jQFormSerializeArrToJson(formSerializeArr){
149
 var jsonObj = {};
150
 jQuery.map( formSerializeArr, function( n, i ) {
151
     jsonObj[n.name] = n.value;
152
 });
153
 return jsonObj;
154
}
155
 
156
</script>
157
 
158
<style>
159
.loading-image {
160
position: fixed;
161
top: 50%;
162
left: 50%;
163
margin-top: -50px;
164
margin-left: -100px;
165
z-index: 100;
166
}
167
</style>
168
 
169
</head>
170
 
171
<body>
172
<div class="container">
173
    <div class="row">
174
         <div class ="header">   
175
		 <h3 class="header">HOTSPOT PARTNER STORE</h3>
176
         <h4 class="header">Powered by Profit Mandi (A Unit of Spice Group)</h4>
177
         </div>
178
 
179
        <div class="header">
180
            <h5 class="header">APPLICATION FOR REGISTRATION</h5>
181
       </div>  
182
        <hr />
183
 
184
        <div class="row">
185
            <div class="col-sm-8">
186
 
187
                <form role="form" name="myform" id ="form"  enctype="multipart/form-data"  data-toggle="validator" novalidate>
22195 amit.gupta 188
                <input type="hidden" name="_id" value="0"/>
22095 kshitij.so 189
             <h4 class="page-header">1. Registered Business Name of HSPS (in Block Letters)</h4>
190
                     <div class="form-group ">
191
 
192
                     <label for=""></label>
22534 ashik.ali 193
                     <input type="text" name="registeredBusinessName" id="demo" class="bform" placeholder="Business Name"  style="text-transform:uppercase;"/>
22095 kshitij.so 194
                     </div>
195
 
196
 
197
             <h4 class="page-header">2. Registered Address (In Block Letters)</h4>
198
 
199
                    <div class="form-group float-label-control">
200
                        <label for="">Line 1</label>
22534 ashik.ali 201
                        <input type="text" name ="line1" class="form-control" placeholder="Line 1" style="text-transform:uppercase;">
22095 kshitij.so 202
                    </div>
203
                     <div class="form-group float-label-control">
204
                        <label for="">Line 2</label>
22534 ashik.ali 205
                        <input type="text" name ="line2"class="form-control" placeholder="Line 2" style="text-transform:uppercase;">
22095 kshitij.so 206
                    </div>
207
                     <div class="form-group float-label-control">
208
                        <label for="">Line 3</label>
22534 ashik.ali 209
                        <input type="text" name="line3" class="form-control" placeholder="Line 3" style="text-transform:uppercase;">
22095 kshitij.so 210
                    </div>
211
                     <div class="form-group float-label-control">
212
                        <label for="">City</label>
22534 ashik.ali 213
                        <input type="text" name="city" class="form-control" placeholder="City" style="text-transform:uppercase;">
22095 kshitij.so 214
                    </div>
215
                      <div class="form-group float-label-control">
216
                        <label for="">District</label>
22534 ashik.ali 217
                        <input type="text" name="district" class="form-control" placeholder="District" style="text-transform:uppercase;">
22095 kshitij.so 218
                    </div>
219
                     <div class="form-group float-label-control">
220
                        <label for="">Pincode</label>
22534 ashik.ali 221
                        <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 222
                      </div>  
223
 
224
                     <div class="form-group float-label-control">
225
 
226
                      <select class="form-control" name = "state" placeholder="State">
227
                       <option value=" ">State</option>
228
                     <option value="Andaman and Nicobar Islands">Andaman and Nicobar Islands</option>
229
                            <option value="Andhra Pradesh">Andhra Pradesh</option>
230
                            <option value="Arunachal Pradesh">Arunachal Pradesh</option>
231
                            <option value="Assam">Assam</option>
232
                            <option value="Bihar">Bihar</option>
233
                            <option value="Chandigarh">Chandigarh</option>
234
                            <option value="Chhattisgarh">Chhattisgarh</option>
235
                            <option value="Dadra and Nagar Haveli">Dadra and Nagar Haveli</option>
236
                            <option value="Daman and Diu">Daman and Diu</option>
237
                            <option value="Delhi">Delhi</option>
238
                            <option value="Goa">Goa</option>
239
                            <option value="Gujarat">Gujarat</option>
240
                            <option value="Haryana">Haryana</option>
241
                            <option value="Himachal Pradesh">Himachal Pradesh</option>
242
                            <option value="Jammu and Kashmir">Jammu and Kashmir</option>
243
                            <option value="Jharkhand">Jharkhand</option>
244
                            <option value="Karnataka">Karnataka</option>
245
                            <option value="Kerala">Kerala</option>
246
                            <option value="Lakshadweep">Lakshadweep</option>
247
                            <option value="Madhya Pradesh">Madhya Pradesh</option>
248
                            <option value="Maharashtra">Maharashtra</option>
249
                            <option value="Manipur">Manipur</option>
250
                            <option value="Meghalaya">Meghalaya</option>
251
                            <option value="Mizoram">Mizoram</option>
252
                            <option value="Nagaland">Nagaland</option>
253
                            <option value="Orissa">Orissa</option>
254
                            <option value="Pondicherry">Pondicherry</option>
255
                            <option value="Punjab">Punjab</option>
256
                            <option value="Rajasthan">Rajasthan</option>
257
                            <option value="Sikkim">Sikkim</option>
258
                            <option value="Tamil Nadu">Tamil Nadu</option>
259
                            <option value="Tripura">Tripura</option>
260
                            <option value="Telangana">Telangana</option>
261
                            <option value="Uttaranchal">Uttaranchal</option>
262
                            <option value="Uttar Pradesh">Uttar Pradesh</option>
263
                            <option value="West Bengal">West Bengal</option>
264
                                              </select>
265
                    </div>
266
 
267
 
268
                      <div class="form-group float-label-control">
269
                        <label for="">Email1</label>
22534 ashik.ali 270
                        <input type="email" class="form-control" name="registeredEmail1" placeholder="Email1" readonly value="${email}" style="text-transform:uppercase;">
22095 kshitij.so 271
                      </div>  
272
                         <p>Example:- xyz<strong>.hsps@gmail.com</strong></p>
273
 
274
 
275
 
276
                        <div class="form-group float-label-control">
277
                        <label for="">Email2</label>
22534 ashik.ali 278
                        <input type="email" class="form-control" name="registeredEmail2" placeholder="Email2" style="text-transform:uppercase;">
22095 kshitij.so 279
                      </div> 
280
 
281
 
282
                       <div class="form-group float-label-control">
283
                        <label for="">Mobile</label>
22534 ashik.ali 284
                        <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 285
                      </div>  
286
 
287
                    <label>Landline</label>
288
                      <div class="form-group Pmpform">
22534 ashik.ali 289
                      <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 290
 
291
 
22534 ashik.ali 292
                      <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 293
                      </div>
294
 
295
 
296
 
297
             <h4 class="page-header">3. Type of Business Entity</h4>
298
 
299
                   <div class="funkyradio">
300
 
301
                    <div class="funkyradio-primary">
302
                        <input type="radio" name="bEntity" id="radio1" value="SaleProprietorship" required>
303
                        <label for="radio1">Proprietor</label>
304
                    </div>
305
                    <div class="funkyradio-primary">
306
                        <input type="radio" name="bEntity" id="radio2" value="Partnership" required>
307
                        <label for="radio2">Partnership</label>
308
                    </div>
309
                    <div class="funkyradio-primary">
310
                        <input type="radio" name="bEntity" id="radio3" value="PrivateLimitedCompany" required>
311
                        <label for="radio3">Private Limited company</label>
312
                    </div>
313
                    <div class="funkyradio-primary">
314
                        <input type="radio" name="bEntity" id="radio4" value="LimitedLiabilityPartnership" required>
315
                        <label for="radio4">Limited Liability Partnership</label>
316
                    </div>
317
                </div>
318
                  <div class ="Entity">
319
                    <div class="SaleProprietorship box" id ="saleSaleProprietorship">Upload <strong>Proprietership proof</strong></div>
320
                     <div class="partnership box" id="salePartnership">Upload <strong>Partnership Deed</strong></div>
321
                     </div>
322
                      <div class="limitedcompany box" id="salePrivateLimitedCompany">
323
                      <div class="form-group float-label-control">
324
                        <label for="">DIN Number</label>
22534 ashik.ali 325
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number" style="text-transform:uppercase;">
22095 kshitij.so 326
                    </div>Upload <strong>Incorporation certificate,Memorandum & Article of association</strong>
327
                      </div>
328
 
329
 
330
                      <div class="LimitedLiabilityPartnership box" id="saleLimitedLiabilityPartnership">
331
 
332
 
333
                           <div class="form-group float-label-control">
334
                        <label for="">DIN Number</label>
22534 ashik.ali 335
                        <input type="text" class="form-control" name="dinNumber" disabled placeholder="DIN Number" style="text-transform:uppercase;">
22095 kshitij.so 336
                    </div>Upload <strong>Registration certificate & partnership Deed</strong>
337
                     </div>
338
 
339
                    <div class = "form-group file upload"> 
340
                   <input type="file" accept="application/pdf,image/*" id="doc" name ="doc_bEntityDoc">
341
 
342
                   <input type="hidden" name="bEntityDoc"/>
343
                    </div>
344
 
345
                     <h4 class="page-header">4. Goods And Services Tax Number(GST)</h4>
346
                    <div class="Pmpform">
347
 
348
                        <input type="text" name="gst" class="bform" placeholder="Goods And Services Tax Number"/>
349
                    </div>
350
                     <p>Provide Copy of GST document</p>
351
                    <div class = "file upload"> 
352
                   <input type="file"  accept="application/pdf,image/*" name ="doc_gstDoc">
353
                     <input type="hidden" name="gstDoc"/>
354
                    </div>
355
 
356
 
357
                     <h4 class="page-header">5. Permanent Account Number(PAN)</h4>
358
                    <div class="form-group ">
359
 
360
                     <label for=""></label>
22534 ashik.ali 361
                     <input type="text" name="pan" maxlength="10" class="bform" placeholder="Permanent Account Number" style="text-transform:uppercase;"/></div>
22095 kshitij.so 362
                     <p>Provide Copy of PAN </p>
363
 
364
                    <div class = "form-group file upload"> 
365
 
366
                   <input type="file" accept="application/pdf,image/*" name="doc_panDoc">
367
                     <input type="hidden" name="panDoc"/>
368
                    </div>
369
 
370
 
371
             <h4 class="page-header">6. Full Details Of Business Entity</h4>
372
 
373
                   <div class="funkyradio">
374
                    <div class="funkyradio-primary">
375
                        <input type="radio" name="bPmpDetail" id="business1" value="Proprietor" required>
376
                        <label for="business1">Proprietor</label>
377
                    </div>
378
                    <div class="funkyradio-primary">
379
                        <input type="radio" name="bPmpDetail" id="business2" value="Partners" required>
380
                        <label for="business2">Partners</label>
381
                    </div>
382
                    <div class="funkyradio-primary">
383
                        <input type="radio" name="bPmpDetail" id="business3" value="Directors" required>
384
                        <label for="business3">Directors</label>
385
                    </div>
386
                </div>
387
 
388
                <div class="tablecontainer">
389
   <table class="businessdetail">
390
              <tr> 
391
              <th class ="PMPName">Name</th>
392
              <th  class="PMPAddress">Address</th> 
393
              <th class="PMPtelno">Mobile</th>
394
              <th class="PMPpan">PAN</th>
395
              <th class="PMPAdhaar">Aadhaar Number</th>
396
              <th class="PMPemail">Email</th>
397
              <th class="PMPownership">Share %</th>
398
 
399
               </tr>
400
            <tr>
401
 
22534 ashik.ali 402
                   <td class="form-group"><input type="text" name="proprietorBusineesName"size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 403
                   <td class="form-group"><textarea row="3" name="proprietorAddress"></textarea></td>
22534 ashik.ali 404
                   <td class="form-group"><input type="text" name="proprietorPhone" maxlength="10" pattern="[0-9]{10}"size="10" style="text-transform:uppercase;"></th>
405
                   <td class="form-group"><input type="text" name="proprietorPan" maxlength="10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
406
                    <td class="form-group"><input type="text"  name= "proprietorAdhaar" size="15" style="text-transform:uppercase;"></td>
407
                   <td class="form-group"><input type="email"  name= "proprietorEmail" size="20" style="text-transform:uppercase;"></td>
408
                   <td class="form-group"><input type="text" pattern="[0-9]" name="proprietorOwner" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 409
 
410
                   </tr>
411
 
412
 
413
            </table>
414
 
415
            </div>
416
            <div class="Partners pmp" id= "PmpPartners">
417
            <table class="businessdetail">
418
 
419
             <tr> 
420
              <th class ="PMPName">Name</th>
421
              <th  class="PMPAddress">Address</th> 
422
              <th class="PMPtelno">Mobile</th>
423
              <th class="PMPpan">PAN</th>
424
              <th class="PMPAdhaar">Aadhaar Number</th>
425
              <th class="PMPemail">Email</th>
426
              <th class="PMPownership">Share %</th>
427
 
428
               </tr>
429
                <tr>
430
 
22534 ashik.ali 431
                   <td class="form-group"><input name="partnerName1"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 432
                   <td class="form-group"><textarea name="partnerAddress1" type="text" size="60"></textarea></td>
22534 ashik.ali 433
                   <td class="form-group"><input name = "partnerPhone1" pattern="[0-9]{10}"type="text" size="10" style="text-transform:uppercase;"></th>
434
                   <td class="form-group"><input  name ="partnerPan1"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
435
                    <td class="form-group"><input name="partnerAdhaar1" type="text"  size="15" style="text-transform:uppercase;"></td>
436
                   <td class="form-group"><input name="partnerEmail1" type="email"  size="20" style="text-transform:uppercase;"></td>
437
                   <td class="form-group"><input name="partnerOwner1" type="text"pattern="[0-9]"size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 438
 
439
                   </tr>
440
 
441
 
442
            </table>
443
 
444
                   <table class="businessdetail">
445
 
446
             <tr> 
447
              <th class ="PMPName">Name</th>
448
              <th  class="PMPAddress">Address</th> 
449
              <th class="PMPtelno">Mobile</th>
450
              <th class="PMPpan">PAN</th>
451
              <th class="PMPAdhaar">Aadhaar Number</th>
452
              <th class="PMPemail">Email</th>
453
              <th class="PMPownership">Share %</th>
454
 
455
               </tr>
456
              <tr>
457
 
22534 ashik.ali 458
                   <td class="form-group"><input name="partnerName2"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 459
                   <td class="form-group"><textarea name="partnerAddress2" type="text" size="60"></textarea></td>
22534 ashik.ali 460
                   <td class="form-group"><input name = "partnerPhone2" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
461
                   <td class="businesspan"><input  name ="partnerPan2"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
462
                   <td class="form-group"><input name="partnerAdhaar2" type="text" size="15" style="text-transform:uppercase;"></td>
463
                   <td class="form-group"><input name="partnerEmail2" type="email" size="20" style="text-transform:uppercase;"></td>
464
                   <td class="form-group"><input name="partnerOwner2" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 465
 
466
                   </tr>
467
 
468
            </table>
469
                   <table class="businessdetail">
470
             <tr> 
471
            <th class ="PMPName">Name</th>
472
              <th  class="PMPAddress">Address</th> 
473
              <th class="PMPtelno">Mobile</th>
474
              <th class="PMPpan">PAN</th>
475
              <th class="PMPAdhaar">Aadhaar Number</th>
476
              <th class="PMPemail">Email</th>
477
              <th class="PMPownership">Share %</th>
478
 
479
               </tr>
480
                 <tr>
481
 
22534 ashik.ali 482
                   <td class="form-group"><input name="partnerName3"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 483
                   <td class="form-group"><textarea name="partnerAddress3" type="text" size="60"></textarea></td>
22534 ashik.ali 484
                   <td class="form-group"><input name = "partnerPhone3" type="text"  maxlength = "10" pattern="[0-9]{10}"  size="10" style="text-transform:uppercase;"></th>
485
                   <td class="form-group"><input  name ="partnerPan3"type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
486
                    <td class="form-group"><input name="partnerAdhaar3" type="text" size="15" style="text-transform:uppercase;"></td>
487
                   <td class="form-group"><input name="partnerEmail3"  type="email" size="20" style="text-transform:uppercase;"></td>
488
                   <td class="form-group"><input name="partnerOwner3" pattern="[0-9"  type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 489
 
490
                   </tr>
491
 
492
 
493
            </table>
494
 
495
 
496
 
497
           <table class="businessdetail">
498
       <tr> 
499
                <th class ="PMPName">Name</th>
500
              <th  class="PMPAddress">Address</th> 
501
              <th class="PMPtelno">Mobile</th>
502
              <th class="PMPpan">PAN</th>
503
              <th class="PMPAdhaar">Aadhaar Number</th>
504
              <th class="PMPemail">Email</th>
505
              <th class="PMPownership">Share %</th>
506
               </tr>
507
               <tr>
508
 
22534 ashik.ali 509
                   <td class="form-group"><input name="partnerName4"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 510
                   <td class="form-group"><textarea name="partnerAddress4" type="text" size="60"></textarea></td>
22534 ashik.ali 511
                   <td class="form-group"><input name = "partnerPhone4"  pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
512
                   <td class="form-group"><input  name ="partnerPan4"type="text" maxlength = "10"title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
513
                    <td class="form-group"><input name="partnerAdhaar4" type="text" size="15" style="text-transform:uppercase;"></td>
514
                   <td class="form-group"><input name="partnerEmail4" type="email" size="20" style="text-transform:uppercase;"></td>
515
                   <td class="form-group"><input name="partnerOwner4" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 516
 
517
                   </tr>
518
 
519
 
520
            </table>
521
 
522
            </div>
523
 
524
 
525
             <div class="Directors pmp" id= "PmpDirectors">
526
            <table class="businessdetail">
527
               <tr> 
528
               <th class ="PMPName">Name</th>
529
              <th  class="PMPAddress">Address</th> 
530
              <th class="PMPtelno">Mobile</th>
531
              <th class="PMPpan">PAN</th>
532
              <th class="PMPAdhaar">Aadhaar Number</th>
533
              <th class="PMPemail">Email</th>
534
              <th class="PMPownership">Share %</th>
535
 
536
               </tr>
537
               <tr>
22534 ashik.ali 538
                   <td class="form-group"><input name="shareholderName1"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 539
                   <td class="form-group"><textarea name="shareholderAddress1" type="text" size="60"></textarea></td>
22534 ashik.ali 540
                   <td class="form-group"><input name = "shareholderPhone1" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
541
                   <td class="form-group"><input  name ="shareholderPan1"type="text" maxlength = "10"  title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
542
                   <td class="form-group"><input name="shareholderAdhaar1" type="text" size="15" style="text-transform:uppercase;"></td>
543
                   <td class="form-group"><input name="shareholderEmail1" type="email" size="20" style="text-transform:uppercase;"></td>
544
                   <td class="form-group"><input name="shareholderOwner1" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 545
 
546
                   </tr>
547
 
548
 
549
            </table>
550
 
551
                   <table class="businessdetail">
552
          <tr> 
553
                <th class ="PMPName">Name</th>
554
              <th  class="PMPAddress">Address</th> 
555
              <th class="PMPtelno">Mobile</th>
556
              <th class="PMPpan">PAN</th>
557
              <th class="PMPAdhaar">Aadhaar Number</th>
558
              <th class="PMPemail">Email</th>
559
              <th class="PMPownership">Share %</th>
560
               </tr>
561
                 <tr>
22534 ashik.ali 562
                   <td class="form-group"><input name="shareholderName2"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 563
                   <td class="form-group"><textarea name="shareholderAddress2" type="text" size="60"></textarea></td>
22534 ashik.ali 564
                   <td class="form-group"><input name = "shareholderPhone2" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
565
                   <td class="form-group"><input  name ="shareholderPan2"type="text" maxlength = "10"  title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
566
                    <td class="form-group"><input name="shareholderAdhaar2" type="text" size="15" style="text-transform:uppercase;"></td>
567
                   <td class="form-group"><input name="shareholderEmail2"  type="email" size="20" style="text-transform:uppercase;"></td>
568
                   <td class="form-group"><input name="shareholderOwner2" pattern="[0-9]"  type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 569
 
570
                   </tr>
571
            </table>
572
 
573
                   <table class="businessdetail">
574
              <tr> 
575
                <th class ="PMPName">Name</th>
576
              <th  class="PMPAddress">Address</th> 
577
              <th class="PMPtelno">Mobile</th>
578
              <th class="PMPpan">PAN</th>
579
              <th class="PMPAdhaar">Aadhaar Number</th>
580
              <th class="PMPemail">Email</th>
581
              <th class="PMPownership">Share %</th>
582
 
583
               </tr>
584
                   <tr>
22534 ashik.ali 585
                   <td class="form-group"><input name="shareholderName3"type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 586
                   <td class="form-group"><textarea name="shareholderAddress3" type="text" size="60"></textarea></td>
22534 ashik.ali 587
                   <td class="form-group"><input name = "shareholderPhone3" pattern="[0-9]{10}" type="text" size="10" style="text-transform:uppercase;"></th>
588
                   <td class="form-group"><input  name ="shareholderPan3" type="text" maxlength = "10" title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
589
                   <td class="form-group"><input name="shareholderAdhaar3" type="text" size="15" style="text-transform:uppercase;"></td>
590
                   <td class="form-group"><input name="shareholderEmail3" type="email" size="20" style="text-transform:uppercase;"></td>
591
                   <td class="form-group"><input name="shareholderOwner3" pattern="[0-9]" type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 592
 
593
                   </tr>
594
 
595
            </table>
596
 
597
                   <table class="businessdetail">
598
             <tr> 
599
                <th class ="PMPName">Name</th>
600
              <th  class="PMPAddress">Address</th> 
601
              <th class="PMPtelno">Mobile</th>
602
              <th class="PMPpan">PAN</th>
603
              <th class="PMPAdhaar">Aadhaar Number</th>
604
              <th class="PMPemail">Email</th>
605
              <th class="PMPownership">Share %</th>
606
               </tr>
607
                     <tr>
22534 ashik.ali 608
                   <td class="form-group"><input name="shareholderName4" type="text" size="25" style="text-transform:uppercase;"></td>
22095 kshitij.so 609
                   <td class="form-group"><textarea name="shareholderAddress4" type="text" size="60"></textarea></td>
22534 ashik.ali 610
                   <td class="form-group"><input name = "shareholderPhone4" type="text" pattern="[0-9]{10}" size="10" style="text-transform:uppercase;"></th>
611
                   <td class="form-group"><input  name ="shareholderPan4" type="text" maxlength = "10"  title="Please enter correct pan number"size="10" style="text-transform:uppercase;"></td>
612
                    <td class="form-group"><input name="shareholderAdhaar4" type="text" size="15" style="text-transform:uppercase;"></td>
613
                   <td class="form-group"><input name="shareholderEmail4"  type="email" size="20" style="text-transform:uppercase;"></td>
614
                   <td class="form-group"><input name="shareholderOwner4" pattern="[0-9]"  type="text" size="10" style="text-transform:uppercase;"></td>
22095 kshitij.so 615
 
616
                   </tr>
617
 
618
 
619
            </table>
620
 
621
            </div>
622
 
623
         <h4 class="page-header">7. Store Manager Details</h4>
624
 
625
 
626
                    <div class="form-group">
627
                    <label for="">Name
628
                    <input type="text" name="managerName"placeholder="Name"></label>
629
                    <label for="">Mobile
22534 ashik.ali 630
                        <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 631
                    <label for="">Email
22534 ashik.ali 632
                        <input type="email" name="managerEmail"size="25px" placeholder="Emailid" style="text-transform:uppercase;"> </label>  
22095 kshitij.so 633
 
634
                    </div>
635
 
636
 
637
            <h4 class="page-header">8. Manpower Details</h4>
638
 
639
               <div class="form-group">
640
                    <label for="">Number of Employees
22534 ashik.ali 641
                    <input type="text" pattern="[0-9]" name="noOfEmployees"placeholder="Number of Employees" style="text-transform:uppercase;"></label>
22095 kshitij.so 642
                    <label for="">Number of Management Staff
22534 ashik.ali 643
                        <input type="text" pattern="[0-9]" name="managementStaff" placeholder="Management Staff" style="text-transform:uppercase;"> </label>  
22095 kshitij.so 644
 
645
                    </div>
646
 
647
              <h4 class="page-header">9. Experience In Telecom Trade/other Trade (Brand & Product Category)</h4>
648
                <div class="bcontacts">
649
                   <textarea rows="4" name="experienceinTelecome"cols="50" placeholder="Describe yourself here..."></textarea> 
650
                </div>
651
 
652
            <h4 class="page-header">10. Description of Existing Business & Annual Turnover</h4>
653
                <div class="bcontacts">
654
                      <textarea rows="4" name="descriptionofExistingBusiness"cols="50" placeholder="Describe yourself here..."></textarea>
655
                </div>
656
                <p>Please Provide ITR of last Two years</p>
657
                <div class = "form-group file upload"> 
658
                   <input type="file" accept="application/pdf,image/*" name ="doc_itrDoc">
659
                      <input type="hidden" name="itrDoc"/>
660
                    </div>
661
 
662
 
663
            <h4 class="page-header">11.Business Model</h4>
664
 
665
            <div class="btn-group">
666
                    <label class="btn btn-default">
667
                   <input type="radio" name="businessModel" value="Retailer" required>
668
                   <span>Retailer</span>
669
                  </label>
670
                <label class="btn btn-default">
671
                    <input type="radio" name="businessModel" value="Distributor" required>
672
                    <span>Distributor</span>
673
                </label>
674
                <label class="btn btn-default">
675
                    <input type="radio" name="businessModel" value="Franchises" required>
676
                    <span>Franchise</span>
677
                </label>
678
                  <label class="btn btn-default">
679
                    <input type="radio" name="businessModel" value="Other" required>
680
                    <span>Other</span>
681
                </label>
682
              </div>
683
 
684
 
685
          <h4 class="page-header">12. Selling Online (if yes, please specify Portal Names)</h4>
686
 
687
                    <div class="btn-group">
688
                    <label class="btn btn-default">
689
                   <input type="radio" name="sellingOnline" value="yes">
690
                   <span>Yes</span>
691
                  </label>
692
                <label class="btn btn-default">
693
                    <input type="radio" name="sellingOnline" value="no">
694
                    <span>No</span>
695
                </label>
696
              </div>
697
                   <div class="form-group portal Names" id = "sellingyes">
698
                   <label>Portal Names</label>
22534 ashik.ali 699
                       <input type="text" name="portalName1" size="25" style="text-transform:uppercase;">
700
                       <input type="text" name="portalName2" size="25" style="text-transform:uppercase;">
701
                       <input type="text" name="portalName3" size="25" style="text-transform:uppercase;">
22095 kshitij.so 702
                  </div>
703
            <h4 class="page-header">13. Area of Shop(in Sq Feet)</h4>
704
              <div>
705
                 <div class="form-group">
706
                    <label>
707
 
708
                    <input type="number" name="east"  placeholder="East(Sq Feet)">
709
                    <input type="number" name="west"  placeholder="West(Sq Feet)">
710
                    <input type="number" name="north" placeholder="North(Sq Feet)"> 
711
                    </label>
712
                </div>
713
                    <br>
714
                      <div class="form-group">
715
                    <label>
716
 
717
                    <input type="number" name="south" placeholder="South(Sq Feet)">
718
                    <input type="number" name="front" placeholder="Front(Sq Feet)">
719
                    <input type="number" name="roadSize" placeholder="Road Size in Front(Sq Feet)">
720
 
721
                    </label>
722
                </div>
723
 
724
                  </div>  
725
                  <div class="shopArea">
726
                   <div class="btn-group">
727
                    <label class="btn btn-default">
728
                   <input type="radio" name="shopArea" value="Singleside">
729
                   <span>Single Side</span>
730
                  </label>
731
                <label class="btn btn-default">
732
                    <input type="radio" name="shopArea" value"Twoside">
733
                    <span>Two Side</span>
734
                </label>
735
                  <label class="btn btn-default">
736
                    <input type="radio" name="shopArea" value="Corner">
737
                    <span>Corner</span>
738
                </label>
739
              </div>
740
              </div>
741
 
742
 
743
              <h4 class="page-header">14. Status of Shop</h4>
744
 
745
                 <div class="btn-group">
746
                    <label class="btn btn-default">
747
                   <input type="radio" name="shopStatus" value="semifurnished">
748
                   <span>Semi Furnished</span>
749
                  </label>
750
                <label class="btn btn-default">
751
                    <input type="radio" name="shopStatus" value="fullfurnished">
752
                    <span>Fully Furnished</span>
753
                </label>
754
                </div>
755
 
756
                 <div class="checkboxes status" id ="shopsemifurnished">
757
                 <div class="btn btn-default">
758
   <label for="success1" class="btn btn-success">Flooring<input type="checkbox" name="flooring" 
759
          value ="flooring" id="success1" class="badgebox"><span class="badge">&check;</span></label>
760
        <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>
761
 
762
 
763
              </div>
764
            </div>
765
 
766
<div class ="checkboxes status"  id ="shopfullfurnished">
767
          <div class="row text-center">
768
    <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>
769
        <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>
770
        <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>
771
        <label for="success" class="btn btn-success">Electricity<input type="checkbox" name="electricity" 
772
          value ="yes" id="success" class="badgebox"><span class="badge">&check;</span></label>
773
        <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>
774
  </div>
775
    </div>
776
 
777
 
778
              <h4 class="page-header">15. Shop Available At</h4>
779
 
780
                     <div class="btn-group">
781
                    <label class="btn btn-default">
782
                   <input type="radio" name="shopAvailbility" value="Basement">
783
                   <span>Basement</span>
784
                  </label>
785
                <label class="btn btn-default">
786
                    <input type="radio" name="shopAvailbility" value="Groundfloor">
787
                    <span>Ground Floor</span>
788
                </label>
789
                  <label class="btn btn-default">
790
                    <input type="radio" name="shopAvailbility" value="firstfloor">
791
                    <span>First Floor</span>
792
                </label>
793
 
794
                  <label class="btn btn-default">
795
                    <input type="radio" name="shopAvailbility" value="secondfloor">
796
                    <span>Second Floor</span>
797
                </label>
798
 
799
                 <label class="btn btn-default">
800
                    <input type="radio" name="shopAvailbility" value="thirdfloor">
801
                    <span>Third Floor</span>
802
                </label>
803
                </div>
804
 
805
                <div class="form-group bdetail">
806
                   <p>Provide pictures of the shop from 3 different angles, ceiling and flooring</p>
807
                      <input type="file" name="doc_angleDoc1" accept="application/pdf,image/*" >
808
                      <input type="hidden" name="angleDoc1"/>
809
                      <input type="file" name="doc_angleDoc2" accept="application/pdf,image/*" >
810
                      <input type="hidden" name="angleDoc2"/>
811
                      <input type="file" name="doc_angleDoc3"  accept="application/pdf,image/*" >
812
                      <input type="hidden" name="angleDoc3"/>
813
                      <input type="file" name="doc_angleDoc4"  accept="application/pdf,image/*" >
814
                      <input type="hidden" name="angleDoc4"/>
815
                      <input type="file" name="doc_angleDoc5" accept="application/pdf,image/*">
816
                      <input type="hidden" name="angleDoc5"/>
817
                  </div>
818
 
819
         <h4 class="page-header">16. Location of Shop</h4>
820
                        <div class="btn-group">
821
                    <label class="btn btn-default">
822
                   <input type="radio" name="location" value="shoppingMall">
823
                   <span>Shopping Mall</span>
824
                  </label>
825
                <label class="btn btn-default">
826
                    <input type="radio" name="location" value="MainMobileMarket">
827
                    <span>Main Mobile Market</span>
828
                </label>
829
                  <label class="btn btn-default">
830
                    <input type="radio" name="location" value="LocalMarket">
831
                    <span>Local Market</span>
832
                </label>
833
 
834
                </div>
835
 
836
 
837
 
838
             <h4 class="page-header">17.Nearest Mobile Store</h4>
839
                           <div class="btn-group">
840
                    <label class="btn btn-default">
841
                   <input type="radio" name="nearestStore" value="100mtrs">
842
                   <span>100Mtrs</span>
843
                  </label>
844
                <label class="btn btn-default">
845
                    <input type="radio" name="nearestStore" value="200mtrs">
846
                    <span>200Mtrs</span>
847
                </label>
848
                  <label class="btn btn-default">
849
                    <input type="radio" name="nearestStore" value="500mtrs">
850
                    <span>500Mtrs</span>
851
                </label>
852
 
853
                </div>
854
 
855
                 <div class="form-group location">
856
                   <label>Name of the Shop</label>
22534 ashik.ali 857
                       <input type="text" size ="35" name="storeName" style="text-transform:uppercase;">
22095 kshitij.so 858
                       <br>
859
                       <br>
860
                        <label>Address of the Shop</label>
22534 ashik.ali 861
                       <input type="text" size ="65" name="storeAddress" style="text-transform:uppercase;">
22095 kshitij.so 862
                  </div>
863
 
864
 
865
 
866
            <h4 class="page-header">18. Ownership of Shop</h4>
867
 
868
                    <div class="btn-group">
869
                    <label class="btn btn-default">
870
                   <input type="radio" name="ownership" value="Selfowned">
871
                   <span>Self Owned</span>
872
                  </label>
873
                <label class="btn btn-default">
874
                    <input type="radio" name="ownership" value="Rented">
875
                    <span>Rented</span>
876
                </label>
877
                  <label class="btn btn-default">
878
                    <input type="radio" name="ownership" value="lease">
879
                    <span>Lease</span>
880
                </label>
881
                  </label>
882
                  <label class="btn btn-default">
883
                    <input type="radio" name="ownership" value="collaboration">
884
                    <span>Collaboration</span>
885
                </label>
886
 
887
                </div>
888
 
889
                 <div class="form-group bdetail">
890
                   <p>Provide relevant documents (Electricity bill/Rent Agreement/Lease Deed)to prove the status of ownership</p>
891
                     <input type="file" accept="application/pdf,image/*" name="doc_ownershipDoc">
892
                     <input type="hidden" name="ownershipDoc"/>
893
                   </div>
894
 
895
 
896
           <h4 class="page-header">19. Insurance of Shop (if yes, please provide the copy of the same)</h4>
897
 
898
 
899
                    <div class="btn-group">
900
                    <label class="btn btn-default">
901
                   <input type="radio" name="insurance" value="yes">
902
                   <span>Yes</span>
903
                  </label>
904
                <label class="btn btn-default">
905
                    <input type="radio" name="insurance" value="no">
906
                    <span>No</span>
907
                </label>
908
              </div>
909
 
910
                 <div class="form-group insurance doc"  id= "docyes">
911
                  <p>Please provide copy of insurance document</p>
912
                     <input type="file" accept="application/pdf,image/*" name="doc_insuranceDoc">
913
                      <input type="hidden" name="insuranceDoc"/>
914
                   </div>
915
 
916
 
917
         <h4 class="page-header">20. Loan on Shop (LAP/BL/CC/others)</h4>
918
 
919
                     <div class="btn-group">
920
                    <label class="btn btn-default">
921
                   <input type="radio" name="loan" value="yes">
922
                   <span>Yes</span>
923
                  </label>
924
                <label class="btn btn-default">
925
                    <input type="radio" name="loan" value="no">
926
                    <span>No</span>
927
                </label>
928
              </div>
929
 
930
                 <div class="form-group loan document" id ="documentyes">
931
                  <p>Please provide current statement Letter</p>
932
                     <input type="file" accept="application/pdf,image/*" name="doc_loanDoc">
933
                     <input type="hidden" name="loanDoc"/>
934
                      <p>Please provide current sanction Letter</p>
935
                     <input type="file" accept="application/pdf,image/*" name="doc_sanctionDoc">
936
                     <input type="hidden" name="sanctionDoc"/>
937
                   </div>
938
 
939
 
940
            <h4 class="page-header">21. Bank Name & Address</h4>
941
 
942
                  <div class="form-group float-label-control">
943
                        <label for="">Account Number</label>
22534 ashik.ali 944
                        <input type="text" name="accountNumber"class="form-control" placeholder="Account Number" style="text-transform:uppercase;">
22095 kshitij.so 945
                    </div>
946
                     <div class="form-group float-label-control">
947
                        <label for="">Bank Name</label>
22534 ashik.ali 948
                        <input type="text" name="bankName"class="form-control" placeholder="Bank Name" style="text-transform:uppercase;">
22095 kshitij.so 949
                    </div>
950
                     <div class="form-group float-label-control">
951
                        <label for="">IFSC Code</label>
22534 ashik.ali 952
                        <input type="text" name="ifscCode"class="form-control" placeholder="IFSC Code" style="text-transform:uppercase;">
22095 kshitij.so 953
                    </div>
954
                     <div class="form-group float-label-control">
955
                        <label for="">Branch Name</label>
22534 ashik.ali 956
                        <input type="text" name="branchName" class="form-control" placeholder="Branch Name" style="text-transform:uppercase;">
22095 kshitij.so 957
                    </div>
958
                     <div >
959
                  <p>Please attach the copy of cancelled cheque</p>
960
                      <div class="form-group">
961
                     <input type="file" name="doc_chequeCopy" accept="application/pdf,image/*">
962
                     <input type="hidden" name="chequeCopy"/>
963
                   </div>
964
 
965
 
966
                  <h4 class="page-header">22. HSPS Bank Account Detail</h4> 
967
 
968
                  <p>Please deposit amount of <strong> Rs 1 Lac </strong>as advance payment in following account through NEFT and submit the UTR No.</p>
969
                    <div class="form-group float-label-control">
970
                        <label for="">UTR Number</label>
22534 ashik.ali 971
                        <input type="text" name="utr" class="form-control" placeholder="UTR No" style="text-transform:uppercase;">
22095 kshitij.so 972
                    </div>
973
                    <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>
974
 
975
 
976
 
977
                      <div class ="Account">
978
                      <label>Account Name: New Spice Solutions Pvt Ltd</label><br>
979
                       <label>Bank Name: IndusInd Bank Ltd.</label><br>
980
                        <label>Account No.:201000488351</label><br>
981
                        <label>Branch:M-56, Greater Kailash-II, Main Market New Delhi-110048</label><br>
982
                         <label>IFSC:INDB0000012</label><br>
983
                        </div>
984
 
985
                <div class="submit">
986
                    <button type="submit" class="btn btn-success btn-lg">Submit</button>
987
                </div>
988
 
989
                <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>
990
 
991
 
992
 
993
 
994
 <!--             <fieldset hidden disabled="disabled">
995
              <h4 class="page-header">PMP STORE REGISTRATION APPROVAL</h4>
996
                 <p>(FOR OFFICE USE ONLY)</P>
997
 
998
                <div class=breg>
999
                 <div class=bApproval>
1000
 
1001
                  <label>Recommended by</label>
22534 ashik.ali 1002
                  <input type="text" name = "recommended"class="reg-control" size="50" style="text-transform:uppercase;">
22095 kshitij.so 1003
 
1004
                  </div>
1005
                  <br>
1006
 
1007
                    <div class=bApproval>
1008
                  <label>Business Manager</label>
22534 ashik.ali 1009
                  <input type="text" name=" bManager" class="reg-control" size="50" style="text-transform:uppercase;">
22095 kshitij.so 1010
                </div>
1011
                      <br>
1012
                        <div class=bApproval>
1013
                    <label>Operations Manager</label>
22534 ashik.ali 1014
                  <input type="text"name="operation"class="reg-control"  size="50" style="text-transform:uppercase;">
22095 kshitij.so 1015
                </div>
1016
                  <br>
1017
               <div class=bApproval>
1018
                     <label>BusinessHeadCategoryHead</label>
22534 ashik.ali 1019
                  <input type="text" name="bhead"class="reg-control" size="50" style="text-transform:uppercase;">
22095 kshitij.so 1020
                </div>
1021
 
1022
 
1023
                 </div>
1024
               </fieldset> -->
1025
 
1026
                      </form>
1027
                    </div>
1028
          </div>
1029
   <div class="col-sm-4">
1030
                <div class="panel panel-default">
1031
 
1032
                    <div class="panel-body">
1033
 
1034
 
1035
                   <label>Spice Global Knowledge Park - 6th Floor, Plot No.19A & 19B, Sector 125, Noida, UP - 201301</label>
1036
                   <br>
1037
                    <label>Email - care@profitmandi.com</<label>
1038
                    <br> 
1039
                    <label>Contact - 8588842949 </label>
1040
                    </div>
1041
                </div>
1042
            </div>
1043
 
1044
        </div>
1045
 
1046
    </div>
1047
    </div>
1048
</body>
1049
</html>