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FINANCIAL SERVICES INDIA PVT LTD
Registered & Corporate Office
D.No. 126, Ground Floor, 4th Avenue, Sundar Nagar, Guindy, Chennai, Tamilnadu, India – 600 032
Website:
www.jayaafs126.com
Email:
[email protected]
Ph:
044-2233 0528
AGENT - FORM - JAYAAFS-0005
CODE
NAME
*
AGE
*
PAN
*
FATHER NAME
*
SPOUSE / HUSBAND
*
GENDER
*
MALE
FEMALE
DATE OF BIRTH
*
EDUCATION
*
EXPERIENCE
*
NATIONALITY
*
RELIGION
*
PRESENT ADDRESS
*
PERMANENT ADDRESS
*
CONTACT NO
*
Invalid number
EMAIL ID
BANK NAME
*
A/C NUMBER
*
IFSC CODE
*
BRANCH
*
NOMINEE NAME
NOMINEE (IN CASE MINOR) GUARANTOR
REQUIRED DOCUMENTS
NOTE:
You must have to upload one id proof and address proof.
AADHAR
ChooseFile
PAN
ChooseFile
DL
ChooseFile
RATION CARD
ChooseFile
VOTER CARD
ChooseFile
BANK PASS BOOK FIRST PAGE COPY
ChooseFile
AGENT PHOTO
*
ChooseFile
TERMS & CONDITIONS
Cost of Agent application form is Rs.500/-
Agent application LOGIN Fee is Rs.1250/-
Agent/Agency should be renewed yearly once before the expiry date. All the agents should nominate a nominee at the time of registration.
Agent does not have any right to collect any fees from the Client in case of any violation the Agent/Agency shall be terminated without any notice by the company.
ACKNOWLEDGEMENT
*
I agree to above Terms & Conditions.
Select
Product Name
Price
Quantity
Sub Total
Agent Registration Fee
250
INR
0.00
INR
X
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