7/11/2019 PaymentForm

(ITP Web Registration Acknowledgment Form - Print in Portrait format on A4 size paper)
Date: 11/07/2019

TIN NO: ACK NO. 126623732O

Name of
:Mrs VIDYA NARESH BAWANKAR
Applicant

State for
GST :MAHARASHTRA
calculation Please affix your
latest Photograph
Date of
:17-Mar-1979
Birth

Mode of :Payment by Online (र 472.0) (Successful online payment received

Payment against bank transaction reference number (Trace number):
pay_CsI7YLFyVUPQuk for your NSR web-registration)

Employer
:Angel Broking Limited
Name

Employee
:E77202 Signature
Number
(Please sign in the centre of the box)

Valid Up
:30/08/2019
To Date

Note :
* To complete your registration please visit any Point of Service (POS) office. If you do not complete your registration
within 50 days of issuance of Acknowledgement Number, your data will be purged from the system.
* You need to take print-out of this form to the POS along-with 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/Employment Identity Card].
* NSR registration fee is subject to change as per GST requirement.
* I have read, understood and I agree to the terms and conditions available on NSR website
https:\\nationalskillsregistry.com relating to my joining and using NSR and I agree to the same.

ACKNOWLEDGEMENT SLIP(For the use of POS only)

TIN NO : Ack No : 126623732O
Name of Applicant : Mrs VIDYA NARESH BAWANKAR POS ID :

1. Received the Application form for Registration as ITP in the National Skills Registry and payment made by
ITP for Registration is Payment through Online.

Date:___________
(POS Seal and Signature)

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