SLA360 Chit Funds - Chit Fund Registration Form

SLA360 CHIT FUNDS PVT LTD

7, Avarampalayam Road, Peelamedu, Coimbatore - 641004

Phone: 0422-3130874, Mobile: 78128 96944

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PERSONAL INFORMATION

Name (In Block Letters)

Father/Husband Name

Address as per ID

Date of Birth

Age

Blood Group

Gender

Marital Status

Nationality

Education Qualification

Occupation Type (Mention Full Details)

NOMINEE INFORMATION

Nominee Name

Relationship

CONTACT INFORMATION

Permanent Address

House Status

Since

Phone No.

Mobile No.

Mail ID

Member wallet reference (optional)

For member-to-member wallet bonus. Leave blank if none.

Employee referral code (optional)

Use the staff Employee ID (same as on the Employees list). You may also enter the numeric employee id.

IDENTIFICATION & ADDRESS

Aadhar/PAN Number

Address of Communication

Occupation Address

Income / Salary (Monthly)

DOCUMENT UPLOADS (MANDATORY)

Identity Proof

Click to upload Identity Proof

Address Proof

Click to upload Address Proof

I have read and agree to the Terms and Conditions