Depositor/Organisation Name*

Address Line1*

Address Line2

Address Line3

State*

PIN Code*

Contract Person/Proprietor*

Mob No.* (To be used for OTP Verification)

Landline No./Alternate Mobile No.

Email ID

GSTIN

PAN*

Trade Licence No.

Upload Trade Licence scan file [only .jpg acceptable]

Upload PAN Card scan file [only .jpg acceptable]*

Upload Signature scan file [only .jpg acceptable]*

I agree to the terms and conditions of WBSWC*