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New Repo Agency Registration
Agency Details
Agency Name
Required
Agency Owner Name
Required
Mobile No
Required
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Whatsapp No
Required
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Email Address
Required
Invalid
Agency Address
Required
Agency Pan No
Required
Invalid Pan Card No
Create Login Password
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At least 1 Upper Case,1 Lower Case, 1 Digit, 1 Special Char And Mini 6 and Max 10 Char
Zone
Required
Central India
East India
North East India
North India
South India
West India
State
Required
Chhattisgarh
Madhya Pradesh
City
Required
Ambikapur
Antagarh
Arang
Bacheli
Bagbahera
Bagicha
Baikunthpur
Balod
Balodabazar
Balrampur
Barpalli
Basana
Bastanar
Bastar
Bderajpur
Bemetara
Berla
Bhairongarh
Bhanupratappur
Bharathpur
Bhatapara
Bhilai
Bhilaigarh
Bhopalpatnam
Bilaspur
Bodla
Bokaband
Chandipara
Chhinagarh
Chhuriakala
Chingmut
Chuikhadan
Dabhara
Dallirajhara
Dantewada
Deobhog
Dhamda
Dhamtari
Dharamjaigarh
Dongargarh
Durg
Durgakondal
Fingeshwar
Gariaband
Garpa
Gharghoda
Ilamidi
Jagdalpur
Janjgir
Janjgir Champa
Jarwa
Jashpur
Jashpurnagar
Kabirdham Kawardha
Kanker
Kasdol
Kathdol
Kathghora
Kawardha
Keskal
Khairgarh
Kondagaon
Konta
Korba
Korea
Koyelibeda
Kuakunda
Kunkuri
Kurud
Lohadigundah
Lormi
Luckwada
Mahasamund
Makodi
Manendragarh
Marwahi
Mohla
Mungeli
Nagri
Narainpur
Narayanpur
Neora
Netanar
Odgi
Padamkot
Pakhanjur
Pandaria
Pandishankar
Parasgaon
Pasan
Patan
Pathalgaon
Pendra
Pratappur
Premnagar
Raigarh
Raipur
Rajnandgaon
Rajpur
Ramchandrapur
Saraipali
Saranggarh
Sarona
Semaria
Shakti
Sukma
Surajpur
Surguja
Tapkara
Toynar
Uproda
Wadrainagar
Agency Pan Card Copy
Required
Only png, jpg File
Agency Owner Photo
Required
Only png, jpg File