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    ANNEXURE - A New Revised Format For CSP ID Request On Letterhead 24082016

    Uploaded by

    Bhargav Makwana
    This document is an application for a Customer Service Point (CSP) with Gujarat Infotech Limited. It requests personal information from the applicant such as name, address, contact details, education level, source of funds, and Aadhaar and PAN numbers. It also requests details about the proposed CSP location such as population, number of households and businesses, and expected level of annual business. The applicant must sign to confirm the information, and a bank official must also sign to recommend approval of the CSP application.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    ANNEXURE - A New Revised Format For CSP ID Request On Letterhead 24082016

    Uploaded by

    Bhargav Makwana
    148 views1 page
    This document is an application for a Customer Service Point (CSP) with Gujarat Infotech Limited. It requests personal information from the applicant such as name, address, contact details, education level, source of funds, and Aadhaar and PAN numbers. It also requests details about the proposed CSP location such as population, number of households and businesses, and expected level of annual business. The applicant must sign to confirm the information, and a bank official must also sign to recommend approval of the CSP application.

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    Original Title

    ANNEXURE- A New Revised Format for CSP ID Request on Letterhead 24082016

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    This document is an application for a Customer Service Point (CSP) with Gujarat Infotech Limited. It requests personal information from the applicant such as name, address, contact details, education level, source of funds, and Aadhaar and PAN numbers. It also requests details about the proposed CSP location such as population, number of households and businesses, and expected level of annual business. The applicant must sign to confirm the information, and a bank official must also sign to recommend approval of the CSP application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    148 views1 page

    ANNEXURE - A New Revised Format For CSP ID Request On Letterhead 24082016

    Uploaded by

    Bhargav Makwana
    This document is an application for a Customer Service Point (CSP) with Gujarat Infotech Limited. It requests personal information from the applicant such as name, address, contact details, education level, source of funds, and Aadhaar and PAN numbers. It also requests details about the proposed CSP location such as population, number of households and businesses, and expected level of annual business. The applicant must sign to confirm the information, and a bank official must also sign to recommend approval of the CSP application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    GUJARAT INFOTECH LIMITED

    Information technology for better services to citizen


    IS O 90 0 1: 2 0 08 & 27 0 01 : 2 00 5 Ce rt i f ie d
    JAMSAB, A-2, 2nd Floor, Jay Tower, Ankur Complex, Naranpura, Ahmedabad 380013
    Phone: 079-27452276, 27485109, 27457650, Fax: 079-27414250
    E-Mail: [email protected], Website: www.gujaratinfotech.com, www.jamsab.com, gram-seva.org
    APPLICATION FOR CUSTOMER SERVICE POINT (CSP) (ANNEXURE –A)
    1. Link Branch Name : __________________________ Link Branch Code: _________ Region: ________
    2. Name of Applicant: ________________________________________________
    3. Address of CSP location: ____________________________________________ Passport size
    4. Town/Village Name: _______________________________________________ photo of
    applicant to
    Block/Sub District/Gram Panchayat __________________________________ be affixed
    5. SSA /Ward details: ________________________________________________
    6. District: _______________________ State: Gujarat Pin Code: ____________________
    7. Latitude: __________________ Longitude: __________________ Distance of Nearest CSP ________
    8. BC name: Gujarat Infotech Ltd. BC code: 3B330000
    9. PERSONAL DETAILS OF CSP:
    Date of Birth Education Qualification*
    Age Source of funds for Business
    Place of Business Rented/Owned No. of years of Stay in the present location
    Aadhaar No * PAN Card No*
    Bank A/C No* Branch name

    (* Photo copies of documents certified by the applicant to be enclosed.)


    10. Contact Details:
    Business Address; Phone No: Mobile No: Fax No:
    ________________________________________________________________________________
    ________________________________________________________________________________
    Residence Address; Phone No: Mobile No:
    ________________________________________________________________________________
    ________________________________________________________________________________
    11. Business Potential:
    Total Population of the area No. of expected Accounts

    Annual business Expected Approximate No. of business


    establishments
    No. of households Potential business through
    Migrant workers
    Main activity of people in the area

    Signature of Applicant/CSP (Bank Mitra) Signature of Authorised Official (BC)


    Date: with stamp

    We have verified the KYC documents and recommend allot CSP code, Link Branch_______________ Branch Manager Signature:

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