Block/District Level Partner Application*
All Services at your Site - Become our Chanel partner ( PAN / AEPS / PMG DISHA / Micro ATM / ADHAR etc . )
Email address *
Select Applicant type *
Applicant Full Name *
Father Name *
Current profession of applicant *
Name of Business *
PAN Number Applicant *
Resident Address *
Full Address Business/Shop/ Center *
State *
Aadhar number *
Mobile Number *
Email Address *
Upload aadhar scan *
Required
Upload Passport Size Photo *
Required
Upload PAN scan *
Required
Bank Passbook/Statement scanned *
Required
Submit
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