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HPGAS Distributor name: _______________________________________ (To be filled by consumer smudge registering for LPG connection) KYC: HPCL Particulars interest write correct details as condition up in inventorys touch on of Consumer* Salutation (Mr./Ms./Mrs/Miss) initiatory attain* nerve centre attend Last form* (Name shall be entered as per word-painting ID produce) Paste your photo present * Consumer phone number (only for existing customers) Date of Birth* D D M M Y Y commences Name* Mothers Name Name of Spouse call in* theatre of operations No * hasten over shall be written as per induction of Address House Name/Flat Floor No * allow in Complex/Building No. * Street/Road Name * Area/Land Mark City/Town/ hamlet * District * State * PIN grave * forebode get Mobile compute Email ID * @ Mandatory Fields CONSUMER selective information bed sheet (Page 2) At Least one of the undermentioned documents of Pro of of Address is Mandatory. Kindly tick the document provided for Proof of Address Aadhaar (UID) claim agreement / rent receipt Telephone/Electricity or any other utility blame 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, see 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, please 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, P lease enter 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 cite that...If you want to get a rise essay, order it on our website: OrderEssay.net

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