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Marital Status :
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Gross Annual Income Details :
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1-5 Lac
5-10 Lac
10-25 Lac
25 Lacs-1 crore
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place of incorporation :
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PAN No. :
Registration No.(e.g. CIN) :
Status :
---Select---
Private Limited Co
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Charities
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Address Detail
Address for correspondence :
City/town/village :
Pin Code :
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Contact Details
Tel.(Off.) :
Tel.(Res.) :
Mobile No :.
Fax No. :
Email address :
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Same as above
Address for correspondence :
City/town/village :
Pin Code :
State :
Country :
Specify the proof of address submitted for registered address :
Other Details
Gross Annual Income Details :
Below Rs 1 Lac
1-5 Lac
5-10 Lac
10-25 Lac
25 Lacs-1 crore
More then 1 crore
Net-worth Amount :
Net-worth Date :
Occupation :
Private Sector
Public Sector
Government Service
Business
Professional
Agriculturist
Retired
Housewife
Others
Please Selects, if applicable, for any of your
authorized signatories/ Promoters/ Partners/ Karta/ Trustees/ whole time directors :
Politically Exposed Person (PEP)
Related to a Politically Exposed Person (PEP)
Any Other Information :
Upload Signature :(Only jpg,png,jpeg Format File)
*
Upload Photo :(Only jpg,png,jpeg Format File)
*
Upload Document :(Only xlsx,xls,pdf,docx,doc Format File)
*
Confirmation Code * :
I agree to all
terms & conditions.
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