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Agency Details

Agency/Member Name *

Registered Address *

District *

Rural/Municipality *

Ward No *

Tole

Email

Contact No. *

Fax

Main Task Done by Agency

No of Employee/Staff Yearly Transaction Amount

Upload Logo * Please upload valid image file, size not more than 2MB.

Location Coordinates * Drag marker to your agency address or scroll your address on map and click to get a marker.

Registration Details

PAN/VAT number *

Registration Authority *

Paid Up Captial *

Specialize Sector *

Company Established At *

Shareholder Details

Name *

Share(%) *

Contact No *

Upload Photo * Please upload valid image file, size not more than 2MB.

Attach Documents

Name *

Upload Document * Please upload valid image or pdf file, size not more than 2MB.

Name *

Upload Document * Please upload valid image or pdf file, size not more than 2MB.

Name *

Upload Document * Please upload valid image or pdf file, size not more than 2MB.

Name *

Upload Document * Please upload valid image or pdf file, size not more than 2MB.

Name *

Upload Document * Please upload valid image or pdf file, size not more than 2MB.

Authorized Person Details

Name *

Post *

Mobile No. * Please type a correct mobile number, this will be used to update you all information, request and activities of AAN.

Upload Photo * Please upload valid image file, size not more than 2MB.

Upload Signature * Please upload valid image file, size not more than 2MB.

Upload Stamp * Please upload valid image file, size not more than 2MB.

Proxy Details

Name *

Post *

Email Address *

Mobile No. * Please type a correct mobile number, this will be used to update you proxy related all information, request and activities of AAN.

Upload Photo * Please upload valid image file, size not more than 2MB.

Upload Signature * Please upload valid image file, size not more than 2MB.

Login Details

Username *

Password *

Confirm Password *