Online Application for New Serve Seva Kendra (SSK)
Note: All fields are mandatory.
Applicant Details
Application For
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Business Associate (BA)
Distributor (DTB)
Applicant Type
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Individual
Company / Trust / Firm
Applicant Title
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Mr
Mrs
Miss
Shrimati
Applicant Full Name
Write Full Name as per Aadhaar Card
Applicant Date of Birth
Mobile No
Verification Code will be sent on this Mobile no.
Alternate Mobile No
Email ID
Verification Code will be sent on this Email ID.
Highest Educational Qualification
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Matriculation (SSC)
Higher Secondary (HSC)
Graduate
Post Graduate
Current Occupation
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Business
Politician
Government Service
Private Service
Farmer
Retired
House Wife
Student
Generalist
Advocate
Other
Any Existing Business?
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Yes
No
Reference Details
How do you know about us ?
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SSK Distributor
SSK BA
NPST Employee
Internet Search / Website
Friends / Relative
Email
Facebook
Twitter
Instagram
YouTube
Whatsapp
Newspaper AD
Banner / Hording
Shop / Office Address
Address should be as per Proof of Address (POA) Document(s)
Shop/Office Name
Property Type
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Owned
Rented
State / UT
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Andhra Pradesh
Assam
Delhi
Goa
Gujarat
Haryana
Karnataka
Ladakh
Madhya Pradesh
Maharashtra
Punjab
Rajasthan
Telangana
Uttar Pradesh
West Bengal
District
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Taluka / Tehsil
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Village / Area
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Other - Not in above list
If your Village / Area is not in above list, select 'Other - Not in above list' and enter your Village / Area name.
Address Line 1
Address Line 2
Landmark
PIN Code
Village / Area Governance Body
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Municipal Corporation (महानगर पालिका)
Municipality (नगर पालिका)
Municipal Council (नगर परिषद)
Nagar Panchayat (नगर पंचायत)
Cantonment Board (छावनी परिषद)
Gram Panchayat (ग्राम पंचायत)
Declarations
I hereby declare that
1. The above information furnished by me is true & correct to the best of my knowledge and belief.
2. NPST or it's Representative can CALL me during their working Days/Hours and/or send SMS / Email for further communication.