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Registration of Bio-Data Part -I
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*
Mandatory Field
1.Name
*
Shri
Smt
Dr.
Mr.
Ms.
2.Director Identification Number
(if available)
3.Income Tax PAN
*
4(a). Gender
*
4(b). Nationality
*
Male
Female
5(a).Fathers's Name
*
5(b).Mother's Name
*
5(c).Marital Status
*
5(d).Spouse Name
Married
Unmarried
6.Date of Birth
*
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
(eligibility age 45 to 65 years)
7. Present Position :
*
8(a).Present Address
*
Pincode
*
City
*
State
*
Select
ANDHRA PRADESH
ASSAM
BIHAR
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU & KASHMIR
KARNATAKA
KERALA
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
NAGALAND
ODISHA
PUNJAB
RAJASTHAN
SIKKIM
TAMILNADU
TRIPURA
UTTAR PRADESH
WEST BENGAL
ANDAMAN & NICOBAR ISLANDS
CHANDIGARH
NCT OF DELHI
GOA
PUDUCHERRY
ARUNACHAL PRADESH
MIZORAM
DADRA NAGARHAVLI
DAMAN AND DIU
LAKSHADWEEP
JHARKHAND
UTTARAKHAND
CHHATTISGARH
TELANGANA
LADAKH
Landline Number ex.(0xx-xxxxxxx)
8(b).Permanent Address
*
Tick if same as Present Address
Pincode
*
City
*
State
*
Select
ANDHRA PRADESH
ASSAM
BIHAR
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU & KASHMIR
KARNATAKA
KERALA
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
NAGALAND
ODISHA
PUNJAB
RAJASTHAN
SIKKIM
TAMILNADU
TRIPURA
UTTAR PRADESH
WEST BENGAL
ANDAMAN & NICOBAR ISLANDS
CHANDIGARH
NCT OF DELHI
GOA
PUDUCHERRY
ARUNACHAL PRADESH
MIZORAM
DADRA NAGARHAVLI
DAMAN AND DIU
LAKSHADWEEP
JHARKHAND
UTTARAKHAND
CHHATTISGARH
TELANGANA
LADAKH
8(c).Mobile Number
*
8(d).Email
*
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Note:
*
All field are mandatory