Riyasat Heritage-register

Fill Personal Details

Applicant Name *

Gender *

Male

Female

Date Of Birth *

Email Address *

Select One *

Father

Husband

Father/Husband Name *

Select One *

Pan

Driving License

Voter ID

Rashan Card

ID No *

Aadhar Number *

Select Cast *

Mobile Number *

Zip Code *

City *

State *

Country *

Permanent Address *

Same as Above Address

Postal Address

Applicant Bank Details(Please enter correct Bank details because refund will come in same account)

Applicant Name *

Bank Account Number *

Select Bank *

IFSC CODE *

Bank Branch Address *

Fill Demand Draft Details

Bank Name : ICICI Bank Ltd. A/C Name : New Path Developers LLP A/C Number : 023505011788 IFSC Code : ICIC0000235

Demand Draft/Payment Trasfer Number *

Demand Draft/Online Payment Date *

Select Bank *

Select Amount *

Attachement

Fill Income Details

Category *

Annual Income *

Project Name *

Demo

:- I HAVE ACKNOWLEDGE AND AGREE THAT I HAVE READ AND UNDERSTOOD THE TERM AND CONDITION.

lotteryweb@gmail.com

Supported Payment System

Contact

0000000000

Verify Your OTP

Enter the OTP sent to your mobile number