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eBIZ House
B-18, Sector - 63
NOIDA - 201301 U.P.
INDIA
ACCEPTANCE FORM
Retailer ID 700069543
User Name santoshsaw
Name MR SANTOSH GUPTA
Date of Birth 10/01/1997
Permanent Address C/O-VINOD KUMAR GUPTA,SALARPUR BHANGEL NOIDA
NOIDA-201301,UTTAR PRADESH
INDIA
Contact No. 9717584905
Registration Date 17 August 2017
Introducing eBIZ Representative MR MANIRANJAN RAI
(Sponsor)
DECLARATION:
Please send this form along with following documents to the company’s office
1. A photocopy of any one of the self-attested Govt. issued photo Identification documents.
2. A photocopy of any one of the self-attested Govt. issued documents for address proof.
3. Self-attested Photocopy of PAN card.
NOTE: It is the sole responsibility of the joining eBIZ Retailer to submit authentic documents and information, any discrepancy or any civil/criminal liability arising due to this regard would be the
full and complete responsibility of the said joining eBIZ Retailer. The company shall not be responsible in this regard in any way.
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