Agent Registration
Agency Name*
Parent Company
Agency Address*
City*
Telephone*
Fax
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IATA No.
Type Of Company*
Annual TurnoverINTL (INR)DOM (INR)
 
Company Capital
Authorized (INR)
Country*
Zip *
Moblie*
Agent Email*
Website
Agency Pan No.*
Formation Date
Premise
  
Paid Up (INR)
Products *
Already with Existing Client?
Previous Branch
TDS Exemption (in our name) %
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Please provide the Administrator details
Title*
First Name*
Last Name*
Mobile*
Email*
Remark

If Using Internet Banking, pls provide following details

Bank Name
Branch Name
Branch Code
MICR No
 
Credit Approved by Other Agencies / Consolidators
No. Company Name Amount(INR)
1
2
3