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Agent Registration Form
Applicant's Details
Applicant's Name:*
Residential Address:*
District:*
PIN:*
12 Digit APDCL Consumer No.:*
Mobile Number:*
APDCL Consumer Name:
Sub-Division Name:
Address Proof Type:*
Address Proof Document:*
Upload
ID Proof type:*
ID Proof Document:*
Upload
Firm/Company Type :*
Passport Size Photo:*
Upload
Is the consumer name in electricity bill same as the applicant's name?:*
Company/Firm Details
Company/Firm Name:*
Address:*
District:*
PIN:*
PAN Number:*
PAN Card:*
Upload
GSTIN:*
GST Document:*
Upload
GSTIN Type:*
Declaration