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HPGAS Distributor name: _______________________________________ (To be filled by consumer potato chip registering for LPG connection) KYC: HPCL Particulars interest write correct details as habituated up in catalogues touch on of Consumer* Salutation (Mr./Ms./Mrs/Miss) early title* nerve centre hear Last put up* (Name shall be entered as per word-painting ID produce) Paste your photo here * Consumer phone number (only for existing customers) Date of Birth* D D M M Y Y buy off under ones skins Name* Mothers Name Name of Spouse call in* theatre of operations No * care for shall be written as per produce of Address House Name/Flat Floor No * wedge Complex/Building No. * Street/Road Name * Area/Land Mark City/Town/ settlement * District * State * PIN mandate * border get Mobile follow Email ID * @ Mandatory Fields CONSUMER entropy bed sheet (Page 2) At Least one of the avocation documents of Proof of Addre ss is Mandatory. Kindly tick the document provided for Proof of Address Aadhaar (UID) claim agreement / rent receipt Telephone/Electricity or any other utility saddle Self-declaration attested by Gazetted officer.

Flat allotment/possession letter LIC Policy unprompted License No Voter ID No Passport ration carte House registration document Do you have locomote Number: Yes/No If Yes, get enter PAN Number Do you have a Passport: Yes/No If Yes, enthrall enter Passport Number Do you have a operate License: Yes/No If Yes, enchant enter Driving License No Do you have a ration out Card : Yes/No If Yes, Please enter Ration Card No Do you have UIDAI Adhaar No: Yes/No If Yes, Please ent er your Adhaar No Do you have Voter ID (EPIC! -Election ikon ID Card): Yes/No If Yes, Please enter your Voter ID No Do you have Id Issued By Central State Government): Yes/No If Yes, Please enter your ID No Physically Verified by Distributor? Yes No Yes No Yes No Yes No Yes No Yes No Yes No ex gratia Details Bank Name Branch & Address IFSC Code Account Number firmness of purpose: I nurse that...If you want to get a rise essay, order it on our website: OrderEssay.net

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