Name of Establishment: *

GST No of Establishment: * Legal Entity Type: * Public limited company Private limited company Partnership firm Joint venture companies One person company Sole proprietorship Branch office Non-government organization (NGO) Limited Liability Partnership (LLP) PAN No: * Details of Director / Partner / CEO / HOD:

Name	Contact No	Designation

Type of Place: * Shop Hospital Microbrewery Mall Shop Other (please specify) Preferred Placement Location for Power Bank Unit: * Indoors Near Entrance Other (please specify) Attach an image of the placement location: * Availability of Power Connection at Placement Location: *

Contact Information:

Contact Name: * Email Address: * Phone Number: *

Address: *

Additional Information:

Additional Comments or Requirements: GST Certificate: * PAN Card Director / Partner / Proprietor: * Video holding Aadhar card of Director / Partner / Proprietor (40 seconds):

Terms and Conditions:

By submitting this application, I agree to the terms and conditions of the power bank rental partnership, including revenue sharing and security deposit requirements.

I agree to the terms and conditions.