CHANNEL PARTNER REGISTRATION FORM

(All Fields are mandatory)

1. BASIC DETAILS

a) Name of Firm

b) Contact Person

Registered Office
c)
Address

(Company/Partnership/Pvt Ltd/Prop/LLP/Others)
d) Entity Type
Pls Specify…………………………………………

e) Contact Details

f) Email Id

g) Website

2. STATUTORY DETAILS

a) Pan Card

b) Aadhar Number

c) Rera Number

3. TEAM DETAILS
S.N.O Name Designation Contact Number Photo

1.

2.

3.

4.

5.

I/We ____________________________ hereby declare that the above mentioned details are true
and best to my knowledge and there’s no misleading information.

Name …………………………. Designation ………………………… Signature with company stamp

Associate Relationship Manager

Name …………………………. Code ………………………… Signature ….…………………………