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IRDAI License Number

Aadhaar No

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Full Name

Email address

Phone No

Bank Acc no

Bank IFSC Code

Bank Acc Name

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Garage Listing Details

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Name Of the Garage

Branch Name

Address

Landmark

District

Pincode

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Landline Phone Nos

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Cell Phone Nos

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Working Days

Contact Timing

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Type Of Company

GST No

PAN No

Bank Acc no

Bank IFSC Code

Company Bank Account Name

Authorized Person Name

Designation

Email Address

Phone No

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I/We have read and agree to the Terms and Conditions of Garage Listing & agree to pay the Listing fee of Rs.2500 for one year.

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