Registration Form - The Hive Mall

Applicant Name

Applicant Father Name/Husband Name

Date Of Birth

Phone Number

Reference Name

Aadhar Card Number

Pan Card Number

Address

City

Card Name City

State

Pin Code

Amount

Quote

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Account Details

Account Name:- Modulux Elite Build LLP Collection
Account Number :- 245805002269
Bank Name:- ICICI Bank
IFSC Code :- ICIC0002458
Branch Name :- Hapur