Micro ATM Application Details Individual
Application Status:
Apply Date:
Order ID :
Personal Details
First Name:
Last Name:
Email Id:
Mobile No:
Shop Name:
DBA Name:
Business Type:
Business Category:
Business Entity:
Address Details
Deployment address:
Pincode:
City:
State:
Bank Details
Bank Account Number:
Bank Account Holder Name:
Bank Account Type:
Bank Name:
Bank Branch Name:
IFSC code:
Attachments
Identity Proof
Address Proof
Shop Photo
Passport Size Photo
Copy of Cheque
Other Details
Agreegator PAN:
Sub Merchant PAN NO:
Date of Birth in PAN Card:
Agreegator GST No:
Agreegator GST Address:
Agreegator GST Pincode:
No Of Terminal:
Model: