Full Name *

Mobile Number *

Email Id

Vendor Type

Date of Birth

Gender

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Legal Entity Name *

PAN Number of Legal Entity

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Aadhar Number *

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Business Name *

Vendor / Business Description *

Complete Address *

Pincode *

State *

City *

Vendor Contact No. *

Alternate contact No.

Name of Account Holder*

Bank Account Number *

UPI ID

Select Account Type *

Bank IFSC Code *

Bank Account Proof (Example: Cancelled Cheque) *