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STOCKIEST BOOKING FORM
Personal Information
Reference ID
Reference ID Name
0
*
First Name of the Party
*
Middle Name of the Party
*
Last Name of the Party
*
E-Mail ID
*
Mobile No.
*
Alternate Mobile No.
*
Upload Photo
Please upload valid Image type as PNG, .JPG and .JPEG.
Image size should not exceed than 4 MB
* N.B.:
File size upto be 4 MB is acceptable. Upload Image like .jpg .jpeg, and .png files etc.
Business Information
*
Existing Business(Office/Shop/Store/Firm Name)
*
Nature of Business
Proprietorship
Partnership
*
Office/Shop/Store/Center/Supermarket
Rented
Owned
*
Trade License
Yes
No
*
Have you been convicted of crime? Or is there criminal case against you?
Yes
No
*
Availability of
Computer
Printer
Internet
Web Cam
CCTV
Biometric Device
Other
*
Storage Capacity
Select Option
Small (up to 1000 sq.ft.)
Medium (1000 to 5,000 sq.ft.)
Large (5000 sq. ft. and above)
Location
*
Pin Code
*
Select Location Type
*
Select Region
Select Option
Urban
Suburban
Rural
*
Select Location Name
*
State
*
District
*
House/Street
*
Village
*
Tehsil
Payment Information
Choose your stockiest point & booking offer:
Stockiest Point Registration Amount(Rs.)
Offer Registration Amount(Rs.)
*
Select Booking Amount(Rs.)
Final Due Amount(Rs.)
You have saved(Rs.)
*
Select Mode of Payment
Bank Transfer
Cheque
PhonePe
Paytm
BHIM UPI
GPay
Net Banking
*
Receipt
* N.B.:
File size upto be 4 MB is acceptable. Upload Image like .jpg .jpeg, and .png files etc.
*
UPI Transaction Id
UTR Number
UPI Ref ID
Transaction No.
Cheque No.
Reference Id
Transaction No.
Transaction ID/No.
*
Company Bank Details
Account Name : Plexmo Rising Star
Account Number :50200084474782
IFSC Code : HDFC0009514
*
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