Nextgen Franchisee Application

* Fields are compulsory

Personal Details

Mobile Number *

Do you have a PAN Card? *

Yes

PAN Number *

Pan Card Image Upload *

JPG/PDF File(Size less than 5 MB)

Entity Type *

Applicant Name *

Title *

First Name *

Middle Name

Last Name *

Gender *

Male

Female

Other

Date of Birth *

Current Occupation *

Specially Abled? *

Yes

How did you come to know about Vakrangee Kendra? *

Are you an Ex Employee? *

Yes

Ex Employee Name *

WhatsApp Mobile Number *

Email Address *

Franchisee Address Details

Current Address (As per Address Proof)

Address Line 1 * Maximum of 35 characters allowed.

Address Line 2 Maximum of 35 characters allowed.

Landmark

Maximum of 35 characters allowed.

State *

District *

Village/Town/City *

Pincode *

Permanent Address Same as Current Address

Address Line 1 * Maximum of 35 characters allowed.

Address Line 2 Maximum of 35 characters allowed.

Landmark

Maximum of 35 characters allowed.

State *

District *

Village/Town/City *

Pincode *

Address Proof Type *

Address Proof Number *

Scanned copy *

JPG/PDF File(Size less than 5 MB)

Proposed Vakrangee Kendra Detail

Is the kendra location identified? *

Yes

Address 1 *

Address 2

Landmark

Locality *

State *

District *

Village/Town/City *

Pincode *

Referred By

Employee Name *

Agent Name *

Master Franchisee Name *

Is this Application pertaining to Ownership change? *

Yes

Vakrangee Kendra Model *

Source of fund

Are you an IOCL dealer and opening a Vakrangee Kendra within IOCL licence area? *

Yes

Are you a NAYARA dealer and opening a Vakrangee Kendra within NAYARA licence area? *

Yes

Remarks

Kindly select the relevant instalments you wish to pay now by applying a tick-mark in the relevant selection boxes below.

Basis your selection, you will be guided to our payment gateway page to execute the total payment selected by you, using any of the online payments you find convenient.

Upon successful confirmation of your transaction, you will receive an email from Vakrangee with a receipt of your payment.

Your Selected Model is Model Name	Amount	(Check to Select)
1^st Instalment
2^nd Instalment
3^rd Instalment
Pay All Instalments in One Go and Get 1% discount
Total Amount to Pay

For Payment related queries: CLICK HERE (https://meet.google.com/kke-dxey-fyg) to Join us for a LIVE meeting (Monday to Friday from 10 am to 5 pm)
OR Call our Representative: +91-8291087036
OR Email: frpayments@vakrangee.in

Kindly click “Proceed” to continue or click “Cancel” to discontinue.

Cancel

Model	1^st Instalment	2^nd Instalment	3^rd Instalment	Total Amount	Amount to pay (with 1% discount if being paid one-shot)

Though we will recommend that you use our digital payment gateway solution for a hassle-free payment experience, to facilitate you to make your payment through your bank branch, kindly find below the unique bank account number assigned to you into which you can pay your instalments. The same has also been emailed to you.

Your Unique Virtual Account Number
Bank Account Name	VAKRANGEE LIMITED
Name of the Bank	Axis Bank
Branch Name	Centralised Collection Hub - Airoli Branch, Mumbai
Branch Code	CCH274
Type of Account	Current Account
IFSC Code of Bank	UTIB0CCH274