Outlet Sign Up Form
for new Outlet
Outlet Join
Personal Details
Outlet Name. *
Mobile No. *
--Select Mobile Code--
India (+91)
Bangladesh (+880)
Email ID
PAN No *
Adhar Card No (optional)
Bank Name *
Branch Name
IFSC Code *
Account Number *
Confirm Account Number *
Name of Account Holder *
Address Details
Enter Country *
Enter State *
Enter District *
Enter City *
Address *
Pin Code *
Outlet Details
Select Outlet Type *
Amount *
Joining Commission(%) *
Commission(%) *
Transaction No *
I agree terms and conditions
Submit