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4/20/2017 PaymentForm

(ITPWebRegistrationAcknowledgmentForm)
Date:______________

TINNO: ACKNO.121886417D

NameofApplicant :MrKPMAHESH

Pleaseaffixyour
DateofBirth :01Dec1996 latestPhotograph

:PaymenttoPOS(460)
ModeofPayment
PleasepayexactamountincashtothePOSoffice

EmployerName :

EmployeeNumber : Signature
(Pleasesigninthecentreofthebox)

ValidUpToDate :09/06/2017

Note:
*TocompleteyourregistrationpleasevisitanyPointofService(POS)office.Ifyoudonotcompleteyourregistrationwithin
50daysofissuanceofAcknowledgementNumber,yourdatawillbepurgedfromthesystem.
* You need to take printout of this form to the POS alongwith ORIGINAL proof of Photo Identity [Voter's Id
card/Passport/Driving License/Bank Pass Book (with Photo)/College ID card (not more than 4 years old)/PAN
card/EmploymentIdentityCard].
* I have read, understood and I agree to the terms and conditions available on NSR website
https:\\nationalskillsregistry.comrelatingtomyjoiningandusingNSRandIagreetothesame.

ACKNOWLEDGEMENTSLIP(FortheuseofPOSonly)
TINNO: AckNo:121886417D
NameofApplicant:MrKPMAHESH POSID:
ReceivedtheApplicationformforRegistrationasKnowledgeProfessional(KP)intheNationalSkillsRegistry.
PaymentModeonlyforNSRregistrationofKP:
(Pleaseaffixstamp,signatureanddateoncorrectoption)
ReceivedCashfromKP ReceivedDD Paymentnotcollected
Dated:_______
Rs.460 Drawnon:__________ Paymenttobecollectedfromcompany
Rs.:_____

https://nationalskillsregistry.com/nasscom/pageflows/itp/itpRegistration/ITPPrintFormAction.do 1/1

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