Username*

Email*

First Name

Last Name

Store Name*

https://app.salemanthan.com/store/[your_store]

Address 1*

Address 2

Country*

City/Town

State/County

Postcode/Zip*

Store Phone*

PAN Card Number*

PAN Card Front Side Picture Upload*

Aadhaar Number*

Aadhaar Card Front Side Picture Upload*

Aadhaar Card Back Side Picture Upload*

GST Number

GST Certificate Upload

Password*

Confirm Password*

* Agree  Terms & Conditions