AGENT REGISTRATION Back
1Company Details
Agency Name *
Type*
Pan Number *
Pan Card Image *
Office Phone *
Country *
State *
City *
Address1 * (As per GST. Certificate)
GST Number *
Pin Code *
Agency Logo *
Agency Logo Size must be maximum 500 KB in size. Supported image types are .JPG , JPEG or PNG.
2Personal Info
Agent First Name * (As per PAN Card)
Last Name (As per PAN Card)
Mobile Number *
Date Of Birth *
Email Id * (As per GST. Certificate)
Refered By:
3Login Info
I want my Email to be User id
I want my Mobile Number to be User id
User id*
Password *
Confirm Password *