T – SEVA BANK MITRA

T Seva Centre is a Unit of Bharat Seva Centre LLP

(LLP Identification Number AAF-1650, Registered under
Ministry of Corporate Affairs, Government of India).
# 403, Sree Nilayam, Lanco Hills Road, Manikonda, Hyderabad – 500089
T- SEVA IS A PRIVATE ORGANIZATION, PROVIDES PRIVATE SERVICES FOR SELF EMPLOYMENT OFFER UNDER PRIVATE SECTOR.

APPLICATION FOR T- SEVA BANK MITRA MERCHANT /AGENT

Affix recent passport size color photograph in the adjacent space.

NAME OF THE PLACE (CITY /DISTRICT/MANDAL/PANCHAYAT

Location __________________________________ Dist _____________

1. Name of Applicant : ______________________________________________

2. Father / Husband Name :______________________________________________

3. Qualification :______________________________________________

4. Occupation :______________________________________________

5. Date of Birth :______________________________________________

6. Address for Communication : ______________________________________________

___________________________________________________________________________

Dist. __________________ Pin: ____________ Telephone with STD Code: _______________

Mobile No.___________________________________________________________________

7. E-mail Address : ______________________________________________

8. Time Required for Start Centre :______________________________________________

9. Application cum processing fee details: DD Name – Bharat Seva Centre LLP, Hyderabad
Amount: Rs _________________ Thousand only , DD/UPI/IMPS NO ____________________
Date _______________Drawee Bank: ____________________________________________

10. Please Submit the Identity and address proof of the owner/ applicant along with the
Application: (Color Xerox Copy - Adhaar Card, PAN Card / Voter ID / Ration Card /SSC Memo)
UNDERTAKING
I hereby declare that the information given in this application form is true to the best of my knowledge. In case my application is accepted, I undertake run the centre as per the Rules and regulations of T-
SEVA BANK MITRA in force and also those issued from time to time. The submission of the application does not automatically confer on me the right for AGENT and I shall be bound by the decision of the
management. Jurisdiction for all disputes (if any) relating to T- SEVA BANK MITRA is Hyderabad Courts only. I also hereby undertake that I shall run t seva centre strictly as per MoU/ Agreement and not
conduct parallel or similar to those authorized in the MoU/ Agreement. I understand and agree that the T- SEVA BANK MITRA Approval automatically stands cancelled, if as a Applicant we are not able to
make franchise registration fee after selection within 7days of approval. I understand and agree that, to improve the business, local marketing is utmost important and stretch my marketing activities on my
own as per the market requirement. Agent finalization first cum first serve basis and. Application & Agent Registration fee is non-refundable under any circumstances. T Seva centre ( A Unit of Bharat
Seva Centre LLP) is providing online services assistance collaboration with Merchants/ Online Service Providers / companies. Selected services or facilities are subject to selected agent centers as they
may differ from the demand, Services / commission and surcharges subject to change from time to time. Commission Structure will be provided at the time of registration. All proposed services / products
not provided at a time it will take 1 months time after proper documents completed by the agent, Any service added / deleted from time to time. Franchiser not given any guarantee on any par ticular service
/ product. The applicant should have the business capital, transaction / turnover capability and no business guara ntee / business promotion in any manner from the t seva head office. Timeframe of 25
days to 40days for allotment of login ID’s to the agent is subject to the approval of the concerned authorities /merchants’ T-SEVA shall not provide any kind of government revenue services to the
franchisee/Agent. T-Seva Online / T-SEVA Skill Nation, franchises subject to separate Proposal /MoU and payment. T-SEVA IS A PRIVATE ORGANIZATION, NOT PROVIDE ANY GOVT. SERVICES,
ONCE AMOUNT PAID NOT REFUNDABLE UNDER ANY CERCUSTANCES, ALL DISPUTES SUBJECT TO HYDERABAD COURTS ONLY.

PLACE: SIGNATURE:
NAME:
DATE: