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<body>
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<body>
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<div class="container">
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<div class="container">
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    <div class="row">
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    <div class="row">
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         <div class ="header">   
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         <div class ="header">   
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         <h3 class="header">HOTSPOT PARTNER STORE</h3>
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		 <h3 class="header">HOTSPOT PARTNER STORE</h3>
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         <h4 class="header">Powered by Profit Mandi (A Unit of Spice Group)</h4>
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         <h4 class="header">Powered by Profit Mandi (A Unit of Spice Group)</h4>
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         </div>
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         </div>
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        <div class="header">
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        <div class="header">
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            <h5 class="header">APPLICATION FOR REGISTRATION</h5>
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            <h5 class="header">APPLICATION FOR REGISTRATION</h5>
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        <div class="row">
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        <div class="row">
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            <div class="col-sm-8">
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            <div class="col-sm-8">
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                <form role="form" name="myform" id ="form"  enctype="multipart/form-data"  data-toggle="validator" novalidate>
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                <form role="form" name="myform" id ="form"  enctype="multipart/form-data"  data-toggle="validator" novalidate>
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             <h4 class="page-header">1. Registered Business Name of HSPS(in Block Letters)</h4>
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             <h4 class="page-header">1. Registered Business Name of HSPS (in Block Letters)</h4>
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                     <div class="form-group ">
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                     <div class="form-group ">
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                     <label for=""></label>
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                     <label for=""></label>
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                     <input type="text" name="registeredBusinessName" id="demo" class="bform" placeholder="Business Name"/>
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                     <input type="text" name="registeredBusinessName" id="demo" class="bform" placeholder="Business Name"/>
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                      <div class="form-group float-label-control">
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                      <div class="form-group float-label-control">
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                        <label for="">Email1</label>
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                        <label for="">Email1</label>
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                        <input type="email" class="form-control" name="registeredEmail1" placeholder="Email1">
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                        <input type="email" class="form-control" name="registeredEmail1" placeholder="Email1">
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                      </div>  
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                      </div>  
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                         <p>Example:- xyz.hsps@gmail.com</p>
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                         <p>Example:- xyz<strong>.hsps@gmail.com</strong></p>
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                        <div class="form-group float-label-control">
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                        <div class="form-group float-label-control">
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                        <label for="">Email2</label>
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                        <label for="">Email2</label>
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            </table>
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            </table>
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            </div>
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            </div>
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         <h4 class="page-header">7. Store Manager Detail</h4>
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         <h4 class="page-header">7. Store Manager Details</h4>
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                    <div class="form-group">
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                    <div class="form-group">
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                    <label for="">Name
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                    <label for="">Name
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                    <input type="text" name="managerName"placeholder="Name"></label>
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                    <input type="text" name="managerName"placeholder="Name"></label>
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                    <input type="radio" name="businessModel" value="Distributor" required>
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                    <input type="radio" name="businessModel" value="Distributor" required>
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                    <span>Distributor</span>
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                    <span>Distributor</span>
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                </label>
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                </label>
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                <label class="btn btn-default">
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                <label class="btn btn-default">
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                    <input type="radio" name="businessModel" value="Franchises" required>
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                    <input type="radio" name="businessModel" value="Franchises" required>
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                    <span>Franchises</span>
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                    <span>Franchise</span>
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                </label>
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                </label>
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                  <label class="btn btn-default">
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                  <label class="btn btn-default">
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                    <input type="radio" name="businessModel" value="Other" required>
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                    <input type="radio" name="businessModel" value="Other" required>
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                    <span>Other</span>
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                    <span>Other</span>
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                </label>
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                </label>
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              </div>
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              </div>
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          <h4 class="page-header">12. Selling Online (if yes, Please Specify Portal Names)</h4>
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          <h4 class="page-header">12. Selling Online (if yes, please specify Portal Names)</h4>
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                    <div class="btn-group">
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                    <div class="btn-group">
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                    <label class="btn btn-default">
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                    <label class="btn btn-default">
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                   <input type="radio" name="sellingOnline" value="yes">
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                   <input type="radio" name="sellingOnline" value="yes">
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                   <span>Yes</span>
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                   <span>Yes</span>
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                   <label>Portal Names</label>
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                   <label>Portal Names</label>
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                       <input type="text" name="portalName1" size="25">
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                       <input type="text" name="portalName1" size="25">
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                       <input type="text" name="portalName2" size="25">
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                       <input type="text" name="portalName2" size="25">
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                       <input type="text" name="portalName3" size="25">
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                       <input type="text" name="portalName3" size="25">
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                  </div>
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                  </div>
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            <h4 class="page-header">13. Area of Shop(in sq Feet)</h4>
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            <h4 class="page-header">13. Area of Shop(in Sq Feet)</h4>
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              <div>
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              <div>
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                 <div class="form-group">
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                 <div class="form-group">
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                    <label>
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                    <label>
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                    <input type="number" name="east"  placeholder="East(Sq Feet)">
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                    <input type="number" name="east"  placeholder="East(Sq Feet)">
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                 <div class="checkboxes status" id ="shopsemifurnished">
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                 <div class="checkboxes status" id ="shopsemifurnished">
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                 <div class="btn btn-default">
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                 <div class="btn btn-default">
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   <label for="success1" class="btn btn-success">Flooring<input type="checkbox" name="flooring" 
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   <label for="success1" class="btn btn-success">Flooring<input type="checkbox" name="flooring" 
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          value ="flooring" id="success1" class="badgebox"><span class="badge">&check;</span></label>
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          value ="flooring" id="success1" class="badgebox"><span class="badge">&check;</span></label>
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        <label for="warning1" class="btn btn-success">Cieling<input type="checkbox" name="cieling" value="cieling" id="warning1" class="badgebox"><span class="badge">&check;</span></label>
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        <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>
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              </div>
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              </div>
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            </div>
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            </div>
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                    <span>Third Floor</span>
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                    <span>Third Floor</span>
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                </label>
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                </label>
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                </div>
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                </div>
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                <div class="form-group bdetail">
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                <div class="form-group bdetail">
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                   <p>Provide Pictures of the Shop From 3 different Angles and cieling and floorig</p>
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                   <p>Provide pictures of the shop from 3 different angles, ceiling and flooring</p>
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                      <input type="file" name="angleDoc1" accept="application/pdf,image/*" >
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                      <input type="file" name="angleDoc1" accept="application/pdf,image/*" >
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                      <input type="file" name="angleDoc2" accept="application/pdf,image/*" >
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                      <input type="file" name="angleDoc2" accept="application/pdf,image/*" >
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                     <input type="file" name="angleDoc3"  accept="application/pdf,image/*" >
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                     <input type="file" name="angleDoc3"  accept="application/pdf,image/*" >
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                            <input type="file" name="angleDoc4"  accept="application/pdf,image/*" >
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                            <input type="file" name="angleDoc4"  accept="application/pdf,image/*" >
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                                   <input type="file" name="angleDoc5" accept="application/pdf,image/*">
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                                   <input type="file" name="angleDoc5" accept="application/pdf,image/*">
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                       <input type="text" size ="65" name="storeAddress">
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                       <input type="text" size ="65" name="storeAddress">
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                  </div>
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                  </div>
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            <h4 class="page-header">18. Ownership of shop</h4>
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            <h4 class="page-header">18. Ownership of Shop</h4>
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                    <div class="btn-group">
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                    <div class="btn-group">
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                    <label class="btn btn-default">
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                    <label class="btn btn-default">
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                   <input type="radio" name="ownership" value="Selfowned">
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                   <input type="radio" name="ownership" value="Selfowned">
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                   <span>Self Owned</span>
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                   <span>Self Owned</span>
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                   <p>Provide relevant documents (Electricity bill/Rent Agreement/Lease Deed)to prove the status of ownership</p>
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                   <p>Provide relevant documents (Electricity bill/Rent Agreement/Lease Deed)to prove the status of ownership</p>
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                     <input type="file" accept="application/pdf,image/*" name="ownershipDoc">
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                     <input type="file" accept="application/pdf,image/*" name="ownershipDoc">
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                   </div>
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                   </div>
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           <h4 class="page-header">19. Insurance of Shop (if yes,Please provide the copy of the same)</h4>
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           <h4 class="page-header">19. Insurance of Shop (if yes, please provide the copy of the same)</h4>
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                    <div class="btn-group">
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                    <div class="btn-group">
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                    <label class="btn btn-default">
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                    <label class="btn btn-default">
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                   <input type="radio" name="insurance" value="yes">
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                   <input type="radio" name="insurance" value="yes">
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                  <p>Please provide copy of insurance document</p>
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                  <p>Please provide copy of insurance document</p>
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                     <input type="file" accept="application/pdf,image/*" name="insuranceDoc">
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                     <input type="file" accept="application/pdf,image/*" name="insuranceDoc">
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                   </div>
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                   </div>
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         <h4 class="page-header">20. Loan on shop (LAP/BL/CC/others)</h4>
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         <h4 class="page-header">20. Loan on Shop (LAP/BL/CC/others)</h4>
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                     <div class="btn-group">
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                     <div class="btn-group">
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                    <label class="btn btn-default">
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                    <label class="btn btn-default">
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                   <input type="radio" name="loan" value="yes">
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                   <input type="radio" name="loan" value="yes">
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                   <span>Yes</span>
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                   <span>Yes</span>
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                     <div class="form-group float-label-control">
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                     <div class="form-group float-label-control">
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                        <label for="">Branch Name</label>
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                        <label for="">Branch Name</label>
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                        <input type="text" name="branchName" class="form-control" placeholder="Branch Name">
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                        <input type="text" name="branchName" class="form-control" placeholder="Branch Name">
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                    </div>
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                    </div>
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                     <div >
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                     <div >
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                  <p>Please Attach the copy of cancelled cheque</p>
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                  <p>Please attach the copy of cancelled cheque</p>
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                      <div class="form-group">
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                      <div class="form-group">
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                     <input type="file" name="chequeCopy" accept="application/pdf,image/*">
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                     <input type="file" name="chequeCopy" accept="application/pdf,image/*">
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                   </div>
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                   </div>
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                  <h4 class="page-header">22. HSPS Bank Account Detail</h4> 
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                  <h4 class="page-header">22. HSPS Bank Account Detail</h4> 
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                      <div class ="Account">
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                      <label>Account Name: New Spice Solutions Pvt Ltd</label><br>
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                       <label>Bank Name: Indusind Bank Ltd.</label><br>
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                        <label>Account No.:201000488351</label><br>
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                        <label>Branch:M-56, Greater Kailash-II, Main Market New Delhi-110048</label><br>
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                         <label>IFSC:INDB0000012</label><br>
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                        </div>
-
 
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                  <p>Please deposit amount of <strong> Rs 1 Lac </strong>as advance payment in following account through NEFT/RTGS and submit the UTR No
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                  <p>Please deposit amount of <strong> Rs 1 Lac </strong>as advance payment in following account through NEFT and submit the UTR No.</p>
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                    <div class="form-group float-label-control">
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                    <div class="form-group float-label-control">
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                        <label for="">UTR Number</label>
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                        <label for="">UTR Number</label>
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                        <input type="text" name="utr" class="form-control" placeholder="UTR No">
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                        <input type="text" name="utr" class="form-control" placeholder="UTR No">
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                    </div>
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                    </div>
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                    <p><b>Note:</b> Advance amount deposited shall be adjustable in the first billing. This amount is 100% refundable in case of withdrawl of application by applicant.</p>
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                    <p><b>Note:</b> Advance amount deposited shall be adjustable in the first billing. This amount is 100% refundable in case of withdrawl of application by applicant.</p>
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-
 
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                      <div class ="Account">
-
 
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                      <label>Account Name: New Spice Solutions Pvt Ltd</label><br>
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                       <label>Bank Name: Indusind Bank Ltd.</label><br>
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                        <label>Account No.:201000488351</label><br>
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                        <label>Branch:M-56, Greater Kailash-II, Main Market New Delhi-110048</label><br>
-
 
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                         <label>IFSC:INDB0000012</label><br>
-
 
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                        </div>
-
 
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                <div class="submit">
939
                <div class="submit">
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                    <button type="submit" class="btn btn-success btn-lg">Submit</button>
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                    <button type="submit" class="btn btn-success btn-lg">Submit</button>
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                </div>
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                </div>
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                <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>
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                <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>
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                    <div class="panel-body">
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                    <div class="panel-body">
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                       <label>Email:care@profitmandi.com</label><br>
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                       <label>Email:care@profitmandi.com</label><br>
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                       <label>Contact:8588842949 </label><br>
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                       <label>Contact:8588842949 </label><br>
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                   <label>Address:6th Floor, Global Knowledge Park, Plot No.19A & 19B, Sector 125, Noida, Uttar Pradesh,201301</label>
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                   <label>Address:Spice Global Knowledge Park, 6th Floor, Plot No.19A & 19B, Sector 125, Noida, Uttar Pradesh,201301</label>
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                    </div>
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                    </div>
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                </div>
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                </div>
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            </div>
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            </div>