VLE Registration for Bank Mitr

EXISTING Bank Mitr      NEW Bank Mitr
Area:- Rural   Urban
Kiosk Operator Code(KOID):-
State:
District:
BCA of Bank:
Branch Name:
IFSC Code:
Settlement/OD/Current A/C No:-
CSC/OMT ID:
Block:
Other Block:
G.P:
Village:
PIN Code:
PAN Number:
Upload Pancard Document: (only jpg, jpeg, png, pdf, doc and docx files are allowed)
Aadhaar No:
Upload Aadhar Document: (only jpg, jpeg, png, pdf, doc and docx files are allowed.)
VLE Name: (As on PAN Card)
Date of Birth: (As on PAN Card)
S/O or D/O or W/O: (As on PAN Card)
Mobile 1: (10 Digits Numeric)
Mobile 2:
E-mail ID:
Photo (0-25 KB): (only jpg, jpeg & png files are allowed.)
CSC Location Longitude:
CSC Location Latitude: Get Location
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