Annex-3 APPLICATION FORM FOR EMPANELMENT OF DSA / DMA To The Manager, Can Fin Homes Ltd (Address) Sub: APPLICATION FOR EMPANELMENT AS DIRECT SELLING AGENT (DSA) / DIRECT Marketing agent (DMA) WITH CAN FIN HOMES LTD. I submit herewith my application for the empanelment a Direct Selling Agent (DSA) / Direct Marketing Agent (DMA) for Can Fin Homes Ltd. I have read the terms and conditions relating to the service and I undertake that those are acceptable to me. 1 Full name (in block letters) (Name of the individual/Proprietorship Firm/Partnership/Company 2 Father’s / Husband’s Name 3 Constitution Individual Proprietorship Partnership Company (tick appropriate option) 4 Date of birth / incorporation (DD/MM/YYYY) 5 Age Years Months 6 Address 7 Mobile number 8 Alternate contact number 9 E-mail id 10 i) PAN card no. ii) Aadhar card no. 11 Present occupation 12 Income (Proof to be provided) 13 No. of years in employment 14 Qualification 15 Languages known
Annex-3 APPLICATION FORM FOR EMPANELMENT OF DSA / DMA To The Manager, Can Fin Homes Ltd (Address) Sub: APPLICATION FOR EMPANELMENT AS DIRECT SELLING AGENT (DSA) / DIRECT Marketing agent (DMA) WITH CAN FIN HOMES LTD. I submit herewith my application for the empanelment a Direct Selling Agent (DSA) / Direct Marketing Agent (DMA) for Can Fin Homes Ltd. I have read the terms and conditions relating to the service and I undertake that those are acceptable to me. 1 Full name (in block letters) (Name of the individual/Proprietorship Firm/Partnership/Company 2 Father’s / Husband’s Name 3 Constitution (tick appropriate option) Individual Proprietorship Partnership Company 4 Date of birth / incorporation (DD/MM/YYYY) 5 Age Years Months 6 Address 7 Mobile number 8 Alternate contact number 9 E-mail id 10 i) PAN card no. ii) Aadhar card no. 11 Present occupation 12 Income (Proof to be provided) 13 No. of years in employment 14 Qualification 15 Languages known
180420173422_DSA%20%20Application%20Form.docx