Microfinance Application Form

Below is a simple application form for Micro Finance Company. This form will take approx. 5 min. It will automatically submit your details to government. All your details are secured by SSL security.
In Which State Would You have or form Micro Finance Company?*
Mention the City name*
What Is the Name of the Microfinance you want to register ?*
In case your requested name is not available, please list two alternates, in order of preference.
We will use your alternate names only if your first choice is not available. Please make sure that your alternates are distinct from your first choice.
First Alternate Name*
Second Alternate Name*
Please provide the company address.
Address*
Pin code*

Director details*

Name	Address	State

Capital contribution*
Capital Contribution Ratio*

(Mention the ratio of capital contributed by the directors like if there is equal sharing then ratio will be 50:50)
Authorized capital of the company*
maximum amount per person you plan to disburse as loan
you can provide maximum 50,000 per person

Package	Inclusions
Basic Package	"2 DSC, 2 DIN, PAN, TAN, Bank Opening \| in case of OPC 1DSC/DIN 1st installment only 1000 in Delhi, 2000 in other"

Please provide us the billing details.
Name*
Email*
Contact*
You will now be directed to the payment gateway. Your payment details have been secured by SSL and PayU money payment security
You will now be directed to the payment gateway. Your payment details have been secured by SSL and Mobikwik payment security
You will now be directed to the payment gateway. Your payment details have been secured by SSL and Instamojo payment security
You will now be directed to the payment gateway. Your payment details have been secured by SSL and EBS payment security
lead
Name
This field is for validation purposes and should be left unchanged.

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