1. Application for

Choose the StateDivisionDistrictTahsilVillage

2. Personal Information

Gender : MaleFemale

Date Of Birth

Mobile Number

Whats App Number

Phone Number

PP size Photo maximum 500kb

Voter ID / Aadhar Card maximum 500kb

3. Security Deposit & Bank Details

Type of Security Deposit: Division 10,000/-District 5000/-Tahsil Pratinidhi 2000/-Village Pratinidhi 1000/-

For Mike Additional 2000/- : yesno

Bank Deposit Receipt maximum 500kb

Bank Details

Punjab National Bank

Name of A/c - Sachcha Dost, A/C No: 3242002100012474, IFSC Code - PUNB0324200, Branch: Freegunj, UJJAIN M.P

Paytm Details

Payment by Paytm 09424812103

For Query Please Contact on [email protected]

07067052133, (whats app) 08109913008