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Miscellaneous License/Registration


Form - COMMON SERVICE CENTRE(CSC) REGISTRATION

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Total Expenses : Rs 11800/-

Sponsor Present ? * Yes No




[ After Click On Primary Submit Check your Email ID for Final Submission ]

CSC NAME

VID No
Aadhaar No *
CSC Name *
Applicant Name *
As per mentioned on Aadhaar Card
Gender * Male Female
Date of Birth *
As per Aadhaar Card. (DD/MM/YYYY)
Applicant Photo *
JPG Format, Within 10KB Size
Mobile Number(1) *
Mobile Number(2) *
Email ID *

RESIDENTAIL DETAILS

Residential Type * Rural Urban
State *
District *
Sub District *
Gram Panchayat Name / Word No
Villege/Town/City *
Street *
Police Station *
Post Office *
Pin No *

KIOSK ADDRESS DETAILS

Same as Residental Address ? *
(If Yes, Don't fill Kiosk Address Details) 		Yes No
Location Rural Urban
State
District
Sub District
Gram Panchayat Name/ Word No
Villege/Town/City
Street
Police Station
Post Office
Pin No

BANK DETAILS

Bank Name *
Branch Name *
Account Holder Name *
Account Number *
IFSC Code *
Type of Account * Savings Current
Pan Type *
Pan Number *

DOCUMENTS REQUIRED

Applicant Aadhar Card *
JPG Format, 40 to 80 KB SIZE
Applicant Pan Card *
JPG Format, 30 to 50 KB Size
Applicant Passport Photo *
JPG FORMAT, Maximum 10 KB Size
Applicant Cancel cheque *
JPG Format, 30 to 50 KB Size
Applicant Voter ID/Identity Proof
JPG Format, 40 to 80 KB Size
Centre Out Side Photo *
Must be Geo Tag, Through Android Mobile, JPG Format, Maximum 50 KB Size.
Centre Inside Photo *
Must be Geo Tag, Through Android Mobile, JPG Format, Maximum 50 KB Size.
Applicant Highest Qualification Certificate *
JPG Format, 40 to 80 KB Size

Our Team

ANINDITA ROY
IT Co Ordinator
ARPITA CHAKRABORTY BANERJEE
IT Co Ordinator
Jharna Mallick
Caustomer Care Executive
DEBIKA SUBBA
IT Co-Ordinator
Chhanda Barik
Mobilizer
Gopal Bera
CEO
Mousumi Pal
Tele Caller
PRIYA BISWAKARMA
IT Co Ordinator
Nisha Sarki
Relationship Manager

Contact Info

Visit Us

At-Peerbaba Tower,1st Floor, OT Road, P.O-Inda,P.S-Kharagpur Town, Dist-Paschim Medinipur, State-West Bengal,Pin- 721305

Mail Us

ashadippsc@gmail.com
ashadippublicservicecentre@gmail.com

Call Us

+91 8918726833

Feel free to write your query


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