Partner Registration Form

Full name of the Applicant/Company*

Constitution*

Business Profile*

Email address*

Communication Address*

Business Experience*

Operating States*

Are you DSA of any other bank/NBFC?*

Yes

References

Profile description

Permanent Account Number*

Upload PAN* (jpg/jpeg/pdf formats in maximum 2MB size)

GST number (if applicable)

Upload GST certificate (jpg/jpeg/pdf formats in maximum 2MB size)

Any other attachments (jpg/jpeg/pdf formats in maximum 2MB size)

Bank account details* Upload Cancelled Cheque Leaf (jpg/jpeg/pdf formats in maximum 2MB size)

Name of the Bank*

Name of the Branch*

Account number*

IFS code*

Declaration: I/we declare that the statements in this application and the documents uploaded are true, complete and correct to the best of my/our knowledge and belief. I/we further declare that the company and the authorized employee are not related to any existing employee of Union Bank of India/UBISL. I/We understand that in the event of any information/document being found untrue/incorrect at any stage my/our application is liable to be rejected and if already empaneled, the empanelment is liable to be terminated.