eNAM | Registration

e-NAM Registration Form

Registration Type * :

Registration Level * :

State Mandi

Personal Details

Title * :

First Name * :

Middle Name :

Last Name * :

Gender * :

Date of Birth * :

Relation Type *

Address (Street) * :

Pincode :

State *:

District *:

Tehsil/Sub-district *:

City/Village *:

Post *:

Photo Id Type * :

Photo ID Number * :

Mobile No. * :

FPO Organization Details

Collection Center * :

Email ID *:

Company Name* :

Company Reg. No.* :

License No.* :

Organisation Name* :

Organisation Address* :

Organisation CIN* : Organisation Reg. No.* : Organization CIN/ Reg No* :

Note - Please make sure correct mail ID is mentioned in " Email ID " field as all future communications from eNAM will be sent on same Email ID.

Bank Details

IFSC Code * :

Account Holder Name as per Bank A/C *

Bank Name * :

Bank Account No. * :

Branch Name* :

Confirm Account No.*

Branch Address* :

Upload Copy Of Passbook/Cancelled Check in Support :

Upload One Scan Copy Of Id Proof :

Registration Acknowledgement:

Get SMS Get Email

Captcha letters are case sensitive *