EmailMe Form - Moral E Suvidha AEPS Service Activation Form

Distributor Name
First Middle Last
Retailer Name *
First Middle Last
Retailer Father Name *
First Middle Last
Retailer Date of Birth
DD / MM / YYYY
Agent Id Activation Date
DD / MM / YYYY
Aadhaar Card Number *
Pan Card Number *
Fee Payment Transaction Id *
Note : AEPS ID Activation FEE Paid By Phone Pay and Google Pay Any UPI App - moralesuvidha@sbi
Fee Payment Mode *
Registered Mobile Number *
Bank Name *
Bank Account Number *
Confirm Bank Account Number

Confirm
Bank Branch IFSC Code *
PAN Card Copy *
Note: Upload PAN Card Copy Self Attested
Bank Passbook Copy *
Note: Upload Bank Passbook Card Copy Self Attested
Aadhaar Card Copy (Front) *
Note : Upload Aadhar Copy Self Attested
Aadhaar Back Card Copy (Back) *
Note: Upload Aadhar Card Copy Self Attested
Shop Photo *
Note: Upload Retailer Shop
Unique ID
Image Verification

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