Subject: Re: Team Member KYC Form - Shahbaz Khan
From: Jotform <[email-masked]>
To: [email-masked], [email-masked], [email-masked], [email-masked]
Date: Tue, 21 Feb 2023 05:49:01 -0500

Team Member KYC Form

Full Name

Shahbaz Khan

Father's Name

Md Akhtar Khan

Phone Number

(+91) 9123092635

Full Current
Address

5, Karim Hussain Lane , Circus Avenue,
Kolkata, West Bengal, 700017

Full Permanent Address

5, Karim Hussain Lane, Circus Avenue, Kolkata, West Bengal, 700017,
India

Are you an Indian Citizen

Yes

PAN Number

CTJPK6559G

Upload Copy of PAN Card

PAN.jpg

Aadhar Number

459934833418

Upload a Clear Selfie
without any headgear

IMG_20221211_031541.jpg

You can edit this submission and
view all your submissions
easily.