fincare.girnarsoft.co.in
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urlscan Pro
43.204.40.239
Public Scan
URL:
https://fincare.girnarsoft.co.in/vendor/onboard/MjM1MzoyMDIzLTAzLTIzOjYzZjcxNDA3NmE1YTg6IEdDQVA6IENyZWF0ZV9WZW5kb3I
Submission: On March 09 via manual from US — Scanned from DE
Submission: On March 09 via manual from US — Scanned from DE
Form analysis 3 forms found in the DOM
Name: vendor_form — POST
<form role="form" id="vendor_form" name="vendor_form" method="post" enctype="multipart/form-data" novalidate="novalidate">
<input type="hidden" name="vendor_ip_address" value="172.16.15.20">
<input type="hidden" name="action" value="save_onboard_data">
<input type="hidden" name="billing_entity_name" value="Girnar Capital Private Limited">
<input type="hidden" name="billing_entity_alias" value="Girnar Capital Private Limited">
<input type="hidden" name="billing_entity_id" id="billing_entity_id" value="15">
<div class="row">
<div class="col-md-12 mt-5"></div>
<div class="row width-fix">
<div class="col-md-12">
<div class="form-group">
<h5 class="tile-title vendor-title">General Details :</h5>
</div>
</div>
<div class="col-md-12 ">
<div class="form-group">
<label class="control-label RobotoMedium">
<!-- Are you i.e the vendor registered in India?--> Are you, i.e. the vendor not registered in India? <!--Is International Vendor?--->
</label>
<div class="switch-field">
<input type="radio" value="Yes" id="is-inter_bp-yes" class="is_international_bp" name="is_international_bp">
<label for="is-inter_bp-yes">YES</label>
<input type="radio" value="No" id="is-inter_bp-no" class="is_international_bp" name="is_international_bp">
<label for="is-inter_bp-no">NO</label>
</div>
</div>
</div>
<div class="row gstin_details_div local_detail_div " style="">
<div class="col-md-12">
<div class=" mt-4">
<div class="form-group">
<!--<h5 class="tile-title vendor-title">GSTIN Details :</h5>-->
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">GSTIN Registration Status *</label>
<select class="form-control select-width-fix gstin_reg_status select2-hidden-accessible" name="gstin_reg_status" data-select2-id="65" tabindex="-1" aria-hidden="true">
<option value="" data-select2-id="67">--Select--</option>
<option value="Registered">Registered</option>
<option value="Composite">Composite</option>
<option value="SEZ">SEZ</option>
<option value="Unregistered">Unregistered</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="66" style="width: 350px;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-gstin_reg_status-6p-container"><span class="select2-selection__rendered" id="select2-gstin_reg_status-6p-container"
role="textbox" aria-readonly="true" title="--Select--">--Select--</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper"
aria-hidden="true"></span></span>
</div>
</div>
<div class="gst_all_div pl-0" style="display: none;">
<div id="accordan_1" class="accordion-div gst-div gst-data-div row" data-accord_id="1">
<div class="col-md-12">
<div class="card">
<h6 class="tile-title RobotoMedium" data-toggle="collapse" data-target="#collapse1" aria-expanded="true" aria-controls="collapseOne"> GSTIN <span class="gst_default_addr"><i></i></span>
<i class="fa fa-chevron-down"></i><i class="fa fa-chevron-up"></i>
<!-- <a href="javascript:void(0)" data-accod_id="1" class="trash-gst-div"><i class="fa fa-trash pr-2" aria-hidden="true"></i></a> -->
</h6>
<div id="collapse1" class="collapse show" aria-labelledby="headingOne">
<div class="card-body p-3">
<div class="row">
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">State of Supply *</label>
<select class="form-control select-width-fix gstin_supply_place select2-hidden-accessible" name="gstin_supply_place[1]" tabindex="-1" aria-hidden="true" aria-required="true" data-select2-id="62">
<option value="" data-select2-id="64">Select </option>
<option value="1" data-state_code="35" data-supply_place_name="Andaman & Nicobar Islands" data-sap_code="AN">Andaman & Nicobar Islands | AN | 35</option>
<option value="2" data-state_code="37" data-supply_place_name="Andhra Pradesh" data-sap_code="AP">Andhra Pradesh | AP | 37</option>
<option value="3" data-state_code="12" data-supply_place_name="Arunachal Pradesh" data-sap_code="AR">Arunachal Pradesh | AR | 12</option>
<option value="4" data-state_code="18" data-supply_place_name="Assam" data-sap_code="AS">Assam | AS | 18</option>
<option value="5" data-state_code="10" data-supply_place_name="Bihar" data-sap_code="BR">Bihar | BR | 10</option>
<option value="7" data-state_code="04" data-supply_place_name="Chandigarh" data-sap_code="CH">Chandigarh | CH | 04</option>
<option value="6" data-state_code="22" data-supply_place_name="Chhattishgarh" data-sap_code="CG">Chhattishgarh | CG | 22</option>
<option value="10" data-state_code="26" data-supply_place_name="Dadra & Nagar Haveli" data-sap_code="DN">Dadra & Nagar Haveli | DN | 26</option>
<option value="8" data-state_code="25" data-supply_place_name="Daman & Diu" data-sap_code="DD">Daman & Diu | DD | 25</option>
<option value="9" data-state_code="07" data-supply_place_name="Delhi" data-sap_code="DL">Delhi | DL | 07</option>
<option value="11" data-state_code="30" data-supply_place_name="Goa" data-sap_code="GA">Goa | GA | 30</option>
<option value="12" data-state_code="24" data-supply_place_name="Gujarat" data-sap_code="GJ">Gujarat | GJ | 24</option>
<option value="14" data-state_code="06" data-supply_place_name="Haryana" data-sap_code="HR">Haryana | HR | 06</option>
<option value="13" data-state_code="02" data-supply_place_name="Himachal Pradesh" data-sap_code="HP">Himachal Pradesh | HP | 02</option>
<option value="16" data-state_code="01" data-supply_place_name="Jammu & Kashmir" data-sap_code="JK">Jammu & Kashmir | JK | 01</option>
<option value="15" data-state_code="20" data-supply_place_name="Jharkhand" data-sap_code="JH">Jharkhand | JH | 20</option>
<option value="17" data-state_code="29" data-supply_place_name="Karnataka" data-sap_code="KA">Karnataka | KA | 29</option>
<option value="18" data-state_code="32" data-supply_place_name="Kerala" data-sap_code="KL">Kerala | KL | 32</option>
<option value="19" data-state_code="31" data-supply_place_name="Lakhswadeep" data-sap_code="LD">Lakhswadeep | LD | 31</option>
<option value="23" data-state_code="23" data-supply_place_name="Madhya Pradesh" data-sap_code="MP">Madhya Pradesh | MP | 23</option>
<option value="20" data-state_code="27" data-supply_place_name="Maharashtra" data-sap_code="MH">Maharashtra | MH | 27</option>
<option value="22" data-state_code="14" data-supply_place_name="Manipur" data-sap_code="MN">Manipur | MN | 14</option>
<option value="21" data-state_code="17" data-supply_place_name="Meghalaya" data-sap_code="ML">Meghalaya | ML | 17</option>
<option value="24" data-state_code="15" data-supply_place_name="Mizoram" data-sap_code="MZ">Mizoram | MZ | 15</option>
<option value="25" data-state_code="13" data-supply_place_name="Nagaland" data-sap_code="NL">Nagaland | NL | 13</option>
<option value="26" data-state_code="21" data-supply_place_name="Orissa" data-sap_code="OR">Orissa | OR | 21</option>
<option value="28" data-state_code="34" data-supply_place_name="Pondicherry" data-sap_code="PY">Pondicherry | PY | 34</option>
<option value="27" data-state_code="03" data-supply_place_name="Punjab" data-sap_code="PB">Punjab | PB | 03</option>
<option value="29" data-state_code="08" data-supply_place_name="Rajasthan" data-sap_code="RJ">Rajasthan | RJ | 08</option>
<option value="30" data-state_code="11" data-supply_place_name="Sikkim" data-sap_code="SK">Sikkim | SK | 11</option>
<option value="31" data-state_code="33" data-supply_place_name="Tamilnadu" data-sap_code="TN">Tamilnadu | TN | 33</option>
<option value="33" data-state_code="36" data-supply_place_name="Telangana" data-sap_code="TS">Telangana | TS | 36</option>
<option value="32" data-state_code="16" data-supply_place_name="Tripura" data-sap_code="TR">Tripura | TR | 16</option>
<option value="35" data-state_code="09" data-supply_place_name="Uttar Pradesh" data-sap_code="UP">Uttar Pradesh | UP | 09</option>
<option value="34" data-state_code="05" data-supply_place_name="Uttarakhand" data-sap_code="UK">Uttarakhand | UK | 05</option>
<option value="36" data-state_code="19" data-supply_place_name="West Bengal" data-sap_code="WB">West Bengal | WB | 19</option>
<option value="71" data-state_code="" data-supply_place_name="International" data-sap_code="">International | | </option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="63" style="width: auto;"><span class="selection"><span class="select2-selection select2-selection--single"
role="combobox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-gstin_supply_place1-z9-container"><span class="select2-selection__rendered"
id="select2-gstin_supply_place1-z9-container" role="textbox" aria-readonly="true" title="Select ">Select </span><span class="select2-selection__arrow"
role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">GSTIN *</label>
<div class="getGstNo_class">
<select class="form-control select-width-fix gstin_data getGstNo select2-hidden-accessible" name="gstin_data_select[1]" id="entity_gst_detail_1" data-select2-id="entity_gst_detail_1" tabindex="-1" aria-hidden="true"
aria-required="true">
<option value="" data-select2-id="19">--Select--</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="18" style="width: auto;"><span class="selection"><span class="select2-selection select2-selection--single"
role="combobox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-entity_gst_detail_1-container"><span class="select2-selection__rendered"
id="select2-entity_gst_detail_1-container" role="textbox" aria-readonly="true" title="--Select--">--Select--</span><span class="select2-selection__arrow"
role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
<input type="text" autocomplete="off" class="form-control gstin_data input_box_gst" name="gstin_data[1]" placeholder="Enter GSTIN" aria-required="true">
<!-- <input type="hidden" class="gst_addr_fetch_date" name="gst_addr_fetch_date[1]" > -->
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">GSTIN Registration Doc *</label>
<input type="file" class="form-control document_check" name="gstin_reg_doc[1]" aria-required="true">
</div>
</div>
<div class="col-md-12" id="accordan_gst_addr_div_1" style="display: none;">
<div id="" class="accordion-div addr-accordn-div row">
<div class="col-md-12">
<div class="card">
<h6 class="tile-title RobotoMedium" data-toggle="collapse" data-target="#collapseAddr" aria-expanded="true" aria-controls="collapseOne"> GSTIN Address Details *
<i class="fa fa-chevron-down"></i><i class="fa fa-chevron-up"></i>
<!-- <a href="javascript:void(0)" data-accod_id="1" class="trash-gst-div"><i class="fa fa-trash pr-2" aria-hidden="true"></i></a> -->
</h6>
<div id="collapseAddr" class="collapse show" aria-labelledby="headingOne">
<div class="card-body p-3">
<div class="form-group row fmg">
<div class="col-sm-12 billing-table-container">
<div class="table-responsive">
<label class="control-label RobotoMedium">Principal Place of Business </label>
<table class="table" id="accordan_gst_paddr_1">
<thead>
<tr>
<th class="">Default</th>
<th>Address 1</th>
<th>Address 2</th>
<th>City</th>
<th>Pincode</th>
</tr>
</thead>
<tbody>
<tr class="input-data-row row_gstn tr_gstn1" data-div_id="1">
<td class="">
<div class="form-check">
<input class="form-check-input addr_radio" type="radio" name="is_default_addr[1][1]" checked="" style="width: 75px;" aria-required="true">
</div>
<i class="desc-tip">Select Default</i>
</td>
<td class="">
<input type="text" class="form-control gstin_addr1" readonly="" value="" placeholder="Enter Address 1" name="gstin_addr1[1][1]" style="width: 400px" aria-required="true">
<i class="up-tip">Address 1</i>
</td>
<td class="">
<input type="text" class="form-control gstin_addr1" readonly="" value="" placeholder="Enter Address 2" name="gstin_addr2[1][1]" style="width: 250px" aria-required="true">
<i class="up-tip">Address 2</i>
</td>
<td class="">
<input type="text" class="form-control gstin_city" readonly="" value="" placeholder="Enter City" name="gst_city[1][1]" aria-required="true">
<i class="desc-tip">City</i>
</td>
<td class="">
<input type="text" class="form-control desc-input tb-input gstin_zipcode" readonly="" placeholder="Enter Pincode/Zipcode" name="gst_zipCode[1][1]" aria-required="true">
<i class="desc-tip">Enter Pincode/Zipcode</i>
</td>
<td class="" style="display: none;">
<input type="text" class="form-control desc-input tb-input gstin_state" placeholder="Enter State" name="gst_state[1][1]" aria-required="true">
<i class="desc-tip">Enter State</i>
</td>
<td class="" style="display: none;">
<input type="text" class="form-control only-numeric gstin_country" value="India" placeholder="Enter Country" name="gst_country[1][1]" aria-required="true">
<i class="desc-tip">Enter Country</i>
</td>
</tr>
</tbody>
</table>
</div>
<div class="table-responsive">
<label class="control-label RobotoMedium">Additional Place of Business </label>
<table class="table" id="accordan_gst_addr_1">
<!-- <thead>
<tr>
<th class="">Default</th>
<th width=400>Address 1</th>
<th width=300px>Address 2</th>
<th>City</th>
<th>Pincode/Zipcode</th> -->
<!-- <th>State </th> -->
<!-- <th>Country </th> -->
<!-- <th>Business Type*</th> -->
<!-- <th></th> -->
<!-- </tr>
</thead> -->
<tbody style="max-height:300px;display:block;overflow:scroll">
<!-- <tr class="input-data-row row_gstn tr_gstn1" data-div_id="1">
<td class="">
<div class="form-check">
<input class="form-check-input addr_radio" type="radio" name="is_default_addr" checked>
</div>
<i class="desc-tip">Select Default</i>
</td>
<td class="">
<select class="form-control tb-sel-input gstin_address" id="gstin_addr_11" data-live-search="true" dropupAuto="false" id="" selectOnTab="true" tabindex="0" mobile="true" data-size="6" name='gst_address[1][1]'>
<option value="">Select</option>
</select>
<i class="up-tip">Select Address</i>
</td>
<td class="">
<input type="text" class="form-control gstin_city" value="" placeholder="City" name="gst_city[1][1]" />
<i class="desc-tip">Enter City</i>
</td>
<td class="">
<input type="text" class="form-control desc-input tb-input gstin_zipcode" placeholder="Pincode" name="gst_zipCode[1][1]" />
<i class="desc-tip">Enter Pincode</i>
</td>
<td class="">
<input type="text" class="form-control desc-input tb-input gstin_state" placeholder="State" name="gst_state[1][1]" />
<i class="desc-tip">Enter State</i>
</td>
<td class="">
<input type="text" class="form-control only-numeric gstin_country" value="INDIA" placeholder="Country" name="gst_country[1][1]" />
<i class="desc-tip">Enter Country</i>
</td>
<td>
<input type="text" class="form-control desc-input tb-input gstin_sac_code" placeholder="Business Type" name="gst_business_type[1][1]" />
<i class="desc-tip">Enter Business Type</i>
</td>
<td>
<a href="javascript:void(0)" class="trash-bill" style="display: none;"><i class="fa fa-trash" aria-hidden="true"></i></a>
</td>
</tr> -->
<tr class="input-data-row row_gstn tr_gstn1" data-div_id="1">
<td class="">
<div class="form-check">
<input class="form-check-input addr_radio" type="radio" name="is_default_addr[1][1]" checked="" style="width: 75px;" aria-required="true">
</div>
<i class="desc-tip">Select Default</i>
</td>
<td class="">
<input type="text" class="form-control gstin_addr1" readonly="" value="" placeholder="Enter Address 1" name="gstin_addr1[1][1]" style="width: 400px" aria-required="true">
<i class="up-tip">Address 1</i>
</td>
<td class="">
<input type="text" class="form-control gstin_addr1" readonly="" value="" placeholder="Enter Address 2" name="gstin_addr2[1][1]" style="width: 250px" aria-required="true">
<i class="up-tip">Address 2</i>
</td>
<td class="">
<input type="text" class="form-control gstin_city" readonly="" value="" placeholder="Enter City" name="gst_city[1][1]" aria-required="true">
<i class="desc-tip">City</i>
</td>
<td class="">
<input type="text" class="form-control desc-input tb-input gstin_zipcode" readonly="" placeholder="Enter Pincode/Zipcode" name="gst_zipCode[1][1]" aria-required="true">
<i class="desc-tip">Enter Pincode/Zipcode</i>
</td>
<td class="" style="display: none;">
<input type="text" class="form-control desc-input tb-input gstin_state" placeholder="Enter State" name="gst_state[1][1]" aria-required="true">
<i class="desc-tip">Enter State</i>
</td>
<td class="" style="display: none;">
<input type="text" class="form-control only-numeric gstin_country" value="India" placeholder="Enter Country" name="gst_country[1][1]" aria-required="true">
<i class="desc-tip">Enter Country</i>
</td>
</tr>
<!-- <tr class="bill-calculation">
<td colspan="13" class="add-item">
<div><a href="javascript:void(0)" data-accod_id="1" class="add-item-link"> + Add Address</a></div>
<i style="font-size: 10px;">Maximum 5 rows can be added</i>
</td>
</tr> -->
</tbody>
</table>
</div>
</div>
</div>
</div>
</div>
<!-- <label class="control-label RobotoMedium">GSTIN Address Details *</label> -->
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<!-- <div class="col-md-1"> -->
<!-- <a href="javascript:void(0)" style="display: none;" class="trash-gst-div"><i class="fa fa-trash" aria-hidden="true"></i></a> -->
<!-- </div> -->
</div>
<div class="add-gstin">
<div class="add-item">
<div><a href="javascript:void(0)" class="add-item-gst"> + Add GSTIN</a></div>
<!-- <i style="font-size: 10px;">Maximum 5 rows can be added</i> -->
</div>
</div>
</div>
</div>
</div>
<div class="col-md-4 mt-3">
<div class="form-group">
<label class="control-label RobotoMedium">Vendor Name <small style="font-size: 61%;">(Select/Enter name which will appear on invoices submitted to Girnar Group)</small>*</label>
<div style="display: none" id="vendor_dropdonlist">
<select class="form-control required select2-hidden-accessible" id="client_id" name="entity_name_dropdonlist" data-select2-id="client_id" tabindex="-1" aria-hidden="true" aria-required="true">
<option value="" data-select2-id="4">-Select-</option>
<option value="PT CSI Indonesia">PT CSI Indonesia</option>
<option value="Carbay PTE Ltd">Carbay PTE Ltd</option>
<option value="Carbay Philippines Inc">Carbay Philippines Inc</option>
<option value="CARBAY SERVICES MALAYSIA SDN. BHD.">CARBAY SERVICES MALAYSIA SDN. BHD.</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="3" style="width: auto;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-client_id-container"><span class="select2-selection__rendered" id="select2-client_id-container" role="textbox"
aria-readonly="true" title="-Select-">-Select-</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
<div style="display: none" id="trade_legal_name_dropdonlist">
<select class="form-control required select2-hidden-accessible" id="trade_legal_name" name="trade_legal_name" data-select2-id="trade_legal_name" tabindex="-1" aria-hidden="true" aria-required="true">
<option value="" data-select2-id="14">-Select-</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="13" style="width: auto;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-trade_legal_name-container"><span class="select2-selection__rendered" id="select2-trade_legal_name-container" role="textbox"
aria-readonly="true" title="-Select-">-Select-</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
<input type="text" autocomplete="off" class="form-control " name="vendor_name" id="vendor_name" placeholder="Enter Vendor Name">
</div>
</div>
<!-- <div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Your Relation with the Organisation *</label>
<select class="form-control select-width-fix" tabindex="2" title="Select" name="relation_with_org" id="relation_with_org">
<option value="">--Select--</option>
<?php// echo arrayToDropOptions(getConfigData('CRM_RELATION_WITH_THE_ORIGANISATION')); ?>
</select>
</div>
</div> -->
<div class="col-md-4 mt-3">
<div class="form-group">
<label class="control-label RobotoMedium">Vendor Mobile No <small style="font-size: 70%;">(for OTP verification)</small> *</label>
<input type="text" autocomplete="off" class="form-control" name="contact_no" id="vendor_mobile" placeholder="Enter Vendor Mobile No">
</div>
</div>
<div class="col-md-4 mt-3">
<div class="form-group">
<label class="control-label RobotoMedium">Vendor Email <small style="font-size: 70%;">(for OTP verification)</small> * </label>
<input type="text" autocomplete="off" class="form-control" name="vendor_email" id="vendor_email" placeholder="Enter Vendor Email">
</div>
</div>
<div class="col-md-4">
<label for="buss_entity_type" class="control-label RobotoMedium">Business Entity Type *</label>
<!----required="required" can be added to select box for html5 validation--->
<select class="form-control required buss_entity_type select2-hidden-accessible" data-live-search="true" dropupauto="false" id="buss_entity_type_id" selectontab="true" tabindex="-1" mobile="true" data-size="6" name="buss_entity_type"
data-select2-id="buss_entity_type_id" aria-hidden="true" aria-required="true">
<option value="" data-select2-id="2">--Select--</option>
<!--<option value="Company">Company</option>
<option value="Partnership">Partnership</option>
<option value="Proprietorship">Proprietorship</option>
<option value="Individual">Individual</option>
<option value="Other">Other</option>-->
<option value="Limited Liability Partnership (LLP)">Limited Liability Partnership (LLP)</option>
<option value="Limited/Private Limited/OPC">Limited/Private Limited/OPC</option>
<option value="Individual/Proprietorship">Individual/Proprietorship</option>
<option value="Hindu Undivided Family (HUF)">Hindu Undivided Family (HUF)</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="1" style="width: 360px;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-buss_entity_type_id-container"><span class="select2-selection__rendered" id="select2-buss_entity_type_id-container" role="textbox"
aria-readonly="true" title="--Select--">--Select--</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Business Doc <small>(The incorporation/business certificate/trade license)</small></label>
<input type="file" class="form-control" name="business_doc" accept="application/msword, application/vnd.ms-excel, application/vnd.ms-powerpoint,
text/plain, application/pdf, image/*" id="business_doc" placeholder="">
</div>
</div>
<div class="col-md-4 other_be_type_div" style="display: none;">
<div class="form-group">
<label class="control-label RobotoMedium">Other Business Entity Type *</label>
<input type="text" autocomplete="off" class="form-control" name="other_be_type" id="other_be_type" placeholder="Enter Other Business Entity Type">
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 mt-4">
<div class="form-group">
<h5 class="tile-title vendor-title">Contact Person Details :</h5>
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Title *</label>
<select class="form-control select-width-fix contact_person_title select2-hidden-accessible" name="contact_person_title" data-select2-id="5" tabindex="-1" aria-hidden="true">
<option value="" data-select2-id="7">--Select--</option>
<option value="Mr.">Mr.</option>
<option value="Ms.">Ms.</option>
<!--<option value="Miss">Miss</option>-->
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="6" style="width: 360px;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-contact_person_title-6e-container"><span class="select2-selection__rendered" id="select2-contact_person_title-6e-container"
role="textbox" aria-readonly="true" title="--Select--">--Select--</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper"
aria-hidden="true"></span></span>
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">First Name *</label>
<input type="text" autocomplete="off" class="form-control" id="contact_person_fname" name="contact_person_fname" placeholder="Enter First Name">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Last Name *</label>
<input type="text" autocomplete="off" class="form-control" id="contact_person_lname" name="contact_person_lname" placeholder="Enter Last Name">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Mobile No *</label>
<input type="text" autocomplete="off" class="form-control" name="contact_person_contact_no" placeholder="Enter Mobile No">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Alternate Mobile No </label>
<input type="text" autocomplete="off" class="form-control" name="contact_person_contact_no1" placeholder="Enter Alternate Mobile No">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Email *</label>
<input type="text" autocomplete="off" class="form-control" name="contact_person_email" id="contact_person_email" placeholder="Enter Email">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Finance Dept’s email id *</label>
<input type="text" autocomplete="off" class="form-control" name="finance_dept_email_id" id="finance_dept_email_id" placeholder="Enter Email">
</div>
</div>
</div>
<div class="row vat_details_div width-fix" style="display: none;">
<div class="col-md-12 mt-4">
<div class="form-group">
<h5 class="tile-title vendor-title">TAX Details :</h5>
</div>
</div>
<div class="col-md-12" style="display: none;">
<div class="form-group">
<label class="control-label RobotoMedium">
</label>
<div class="switch-field">
<input type="radio" value="Not_Applicable" id="tax_id_status-no" class="tax_id_status" name="tax_id_status">
<label for="tax_id_status-no">Not Applicable</label>
<input type="radio" value="Applicable" id="tax_id_status-yes" class="tax_id_status" name="tax_id_status" checked="">
<label for="tax_id_status-yes">Applicable</label>
</div>
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Tax ID Number *</label>
<input type="text" autocomplete="off" class="form-control" name="income_tax_id" placeholder="Enter Tax ID Number">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Tax ID Number Doc *</label>
<input type="file" class="form-control form26as_document_name document_check" name="income_tax_doc">
<!-- <small>(document must be pdf,image,doc,docx and less than 3 MB)</small> -->
<!-- <span class="steps-to-download">
<a href="https://fincare.girnarsoft.co.in/utils/how_to_download_TDS_deduction_proof_from_ITR.pdf" target="blank" class="">How to download Tax deposit details<i class="bi bi-link"></i></a>
</span> -->
</div>
</div>
</div>
<div class="row addr_details width-fix" style="display: none;">
<div class="col-md-12 mt-4">
<div class="form-group">
<h5 class="tile-title vendor-title">Address Details :</h5>
</div>
</div>
<div class="col-md-12 billing-table-container">
<div class="form-group row">
<div class="col-sm-12">
<div class="table-responsive">
<table class="table">
<thead>
<tr>
<th class="" style="display: none;">Default</th>
<th width="200px">Address 1*</th>
<th>Address 2</th>
<th>City*</th>
<th width="170px">Country* </th>
<th width="170px" class="th_state_addr">State *</th>
<th class="pin_addr_th">Pincode*</th>
<th></th>
</tr>
</thead>
<tbody>
<tr class="input-data-row addr-div" data-div_id="1">
<td class="" style="display: none;">
<div class="form-check">
<input class="form-check-input addr_radio" type="radio" name="is_addr_default[1]" checked="">
</div>
<i class="desc-tip">Select Default</i>
</td>
<td class="">
<input type="text" class="form-control gstin_city" value="" placeholder="Enter Address1" name="addr_1[1]" disabled="">
<i class="up-tip">Enter Address1</i>
</td>
<td>
<input type="text" class="form-control desc-input addr_2 gstin_sac_code" placeholder="Enter Address2" name="addr_2[1]" disabled="">
<i class="desc-tip">Enter Address2</i>
</td>
<td class="">
<input type="text" class="form-control gstin_city 1" value="" placeholder="Enter City" name="addr_city[1]" disabled="">
<i class="desc-tip">Enter City</i>
</td>
<td class="">
<!-- <input type="text" class="form-control only-numeric gstin_country" value="" placeholder="Enter Country" name="addr_country[1]" /> -->
<div id="for_international" style="display: none">
<select class="form-control select-width-fix gstin_country addr_country_select" name="addr_country_intl[1]" disabled="">
<option value="">--Select--</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Aland Islands">Aland Islands</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia">Bolivia</option>
<option value="Bonaire, Sint Eustatius and Saba">Bonaire, Sint Eustatius and Saba</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Congo, Democratic Republic of the Congo">Congo, Democratic Republic of the Congo</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Cote D'Ivoire">Cote D'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curacao">Curacao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and Mcdonald Islands">Heard Island and Mcdonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran, Islamic Republic of">Iran, Islamic Republic of</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
<option value="Korea, Republic of">Korea, Republic of</option>
<option value="Kosovo">Kosovo</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Macedonia, the Former Yugoslav Republic of">Macedonia, the Former Yugoslav Republic of</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia, Federated States of">Micronesia, Federated States of</option>
<option value="Moldova, Republic of">Moldova, Republic of</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="Netherlands Antilles">Netherlands Antilles</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Reunion">Reunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthelemy">Saint Barthelemy</option>
<option value="Saint Helena">Saint Helena</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Martin">Saint Martin</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Serbia and Montenegro">Serbia and Montenegro</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten">Sint Maarten</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Venezuela">Venezuela</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands, British">Virgin Islands, British</option>
<option value="Virgin Islands, U.s.">Virgin Islands, U.s.</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
</div>
<div id="for_india">
<select class="form-control select-width-fix gstin_country addr_country_select" name="addr_country[1]" disabled="">
<option value="">--Select--</option>
<option value="India">India</option>
</select>
</div>
<i class="desc-tip">Enter Country</i>
</td>
<td class="state_txt_td">
<input type="text" class="form-control desc-input state_input province_state gstin_state state_txt" placeholder="Enter State" required="" name="addr_state[1]" aria-required="true" disabled="">
<i class="desc-tip">Enter Province/State</i>
</td>
<td class="select_state_td" style="display: none;">
<select class="form-control select-width-fix province_state gstin_state select_state" required="" name="" aria-required="true">
<option value="">--Select--</option>
<option value="Andaman & Nicobar Islands">Andaman & Nicobar Islands</option>
<option value="Andhra Pradesh">Andhra Pradesh</option>
<option value="Arunachal Pradesh">Arunachal Pradesh</option>
<option value="Assam">Assam</option>
<option value="Bihar">Bihar</option>
<option value="Chhattishgarh">Chhattishgarh</option>
<option value="Chandigarh">Chandigarh</option>
<option value="Daman & Diu">Daman & Diu</option>
<option value="Delhi">Delhi</option>
<option value="Dadra & Nagar Haveli">Dadra & Nagar Haveli</option>
<option value="Goa">Goa</option>
<option value="Gujarat">Gujarat</option>
<option value="Himachal Pradesh">Himachal Pradesh</option>
<option value="Haryana">Haryana</option>
<option value="Jharkhand">Jharkhand</option>
<option value="Jammu & Kashmir">Jammu & Kashmir</option>
<option value="Karnataka">Karnataka</option>
<option value="Kerala">Kerala</option>
<option value="Lakhswadeep">Lakhswadeep</option>
<option value="Maharashtra">Maharashtra</option>
<option value="Meghalaya">Meghalaya</option>
<option value="Manipur">Manipur</option>
<option value="Madhya Pradesh">Madhya Pradesh</option>
<option value="Mizoram">Mizoram</option>
<option value="Nagaland">Nagaland</option>
<option value="Orissa">Orissa</option>
<option value="Punjab">Punjab</option>
<option value="Pondicherry">Pondicherry</option>
<option value="Rajasthan">Rajasthan</option>
<option value="Sikkim">Sikkim</option>
<option value="Tamilnadu">Tamilnadu</option>
<option value="Tripura">Tripura</option>
<option value="Telangana">Telangana</option>
<option value="Uttarakhand">Uttarakhand</option>
<option value="Uttar Pradesh">Uttar Pradesh</option>
<option value="West Bengal">West Bengal</option>
</select>
<i class="desc-tip">Enter Province/State</i>
</td>
<td class="">
<input type="text" class="form-control desc-input tb-input pincode_input gstin_zipcode" placeholder="Enter Pincode" name="addr_zipCode[1]" disabled="">
<i class="desc-tip">Enter Pincode/Zipcode</i>
</td>
<td>
<a href="javascript:void(0)" class="trash-bill" style="display: none;"><i class="fa fa-trash" aria-hidden="true"></i></a>
</td>
</tr>
<!-- <tr class="bill-calculation add-addr">
<td colspan="13" class="add-item">
<div><a href="javascript:void(0)" data-accod_id="1" class="add-addr-link"> + Add Address</a></div>
<i style="font-size: 10px;">Maximum 5 rows can be added</i>
</td>
</tr> -->
</tbody>
</table>
</div>
</div>
</div>
</div>
</div>
<div class="row pan_div width-fix mb-1" style="display: none;">
<div class="col-md-12 mt-4">
<div class="form-group">
<h5 class="tile-title vendor-title">PAN Details :</h5>
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">PAN *</label>
<input type="text" autocomplete="off" class="form-control pan" id="pan_id" name="pan" placeholder="Enter Pan" aria-required="true" disabled="">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">PAN Image *</label>
<input type="file" class="form-control pan_image" name="pan_image" aria-required="true" disabled="">
</div>
</div>
</div>
<div class="row invoice_div envoice_div" style="display: none;">
<!-- <div class="col-md-12 ">
<div class="form-group">
<h5 class="tile-title vendor-title">E Invoice Details :</h5>
</div>
</div> -->
<div class="col-md-12 mt-2">
<div class="form-group">
<h5 class="tile-title vendor-title">E Invoice Status :</h5>
<div class="switch-field">
<input type="radio" value="Not Applicable" id="einvoice_sts-no" class="einvoice_sts" name="einvoice_sts" checked="">
<label for="einvoice_sts-no">Not Applicable </label>
<input type="radio" value="Applicable" id="einvoice_sts-yes" class="einvoice_sts" name="einvoice_sts">
<label for="einvoice_sts-yes">Applicable</label>
</div>
</div>
</div>
<div class="col-md-12 envoice_data_div mb-3 pl-4" style="display: none;">
<div class="row">
<div class="col-md-4 ">
<div class="form-group">
<label class="control-label RobotoMedium">E-Invoice effective date <span class="einvoice_required"></span></label>
<input class="form-control einvoice_date date_formating" type="text" readonly="" id="einvoice_date" autocomplete="off" name="einvoice_date" placeholder="Enter E Invoice Date" disabled="">
</div>
</div>
</div>
</div>
<!-- <div class="col-md-4 envoice_div">
<div class="form-group">
<label class="control-label RobotoMedium">E Invoice Doc </label>
<input type="file" class="form-control document_check" id="einvoice_doc" name="einvoice_doc" />
</div>
</div> -->
</div>
<div class="row msmed_div" style="display: none;">
<!-- <div class="col-md-12">
<div class="form-group">
<h5 class="tile-title vendor-title">MSMED Details :</h5>
</div>
</div> -->
<div class="col-md-12 mt-2">
<div class="form-group">
<!-- <label class="control-label RobotoMedium">
MSMED Status
</label> -->
<h5 class="tile-title vendor-title">MSME Status :</h5>
<div class="switch-field">
<input type="radio" value="Not Applicable" id="msmed_sts-no" class="msmed_sts" name="msmed_sts">
<label for="msmed_sts-no">Not Applicable </label>
<input type="radio" value="Applicable" id="msmed_sts-yes" class="msmed_sts" name="msmed_sts">
<label for="msmed_sts-yes">Applicable</label>
</div>
</div>
</div>
<div class="col-md-12 msmed_data_div mb-3 pl-4" style="display: none;">
<div class="row">
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">MSME No. <span class="msmed_required"></span></label>
<input type="text" autocomplete="off" class="form-control" name="MSME_number" id="MSME_number" value="" placeholder="Enter MSME No." disabled="">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">MSME Date <span class="msmed_required"></span></label>
<input class="form-control date_formating" type="text" id="msmed_start_date" value="" readonly="" autocomplete="off" name="msmed_start_date" placeholder="Enter MSME Date" disabled="">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">MSME Doc <span class="msmed_required"></span></label>
<input type="file" class="form-control form26as_document_name document_check" id="msmed_doc" name="msmed_doc" disabled="">
</div>
</div>
</div>
</div>
<!-- <div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">MSMED End Date </label>
<input class="form-control date_formating" type="text" id="msmed_end_date" value="" readonly autocomplete='off' name="msmed_end_date" placeholder="Enter MSMED End Date">
</div>
</div> -->
<div class="col-md-4">
<!-- <div class="form-group">
<label class="control-label RobotoMedium">MSMED End Date </label>
<input class="form-control date_formating" type="text" id="msmed_end_date" value="" readonly autocomplete='off' name="msmed_end_date" placeholder="Enter MSMED End Date">
</div> -->
</div>
<div class="col-md-4">
<!-- <div class="form-group">
<label class="control-label RobotoMedium">MSMED End Date </label>
<input class="form-control date_formating" type="text" id="msmed_end_date" value="" readonly autocomplete='off' name="msmed_end_date" placeholder="Enter MSMED End Date">
</div> -->
</div>
</div>
<div class="row ltdc_div" style="display: none;">
<!-- <div class="col-md-12">
<div class="form-group">
<h5 class="tile-title vendor-title">MSMED Details :</h5>
</div>
</div> -->
<!--<div class="col-md-12 mt-2">
<div class="form-group">
<h5 class="tile-title vendor-title">LTDC applicable? :</h5>
<div class="switch-field">
<input type="radio" value="Not_Applicable" id="ltdc_sts-no" class="ltdc_sts" name="ltdc_sts" checked />
<label for="ltdc_sts-no">Not Applicable </label>
<input type="radio" value="Applicable" id="ltdc_sts-yes" class="ltdc_sts" name="ltdc_sts" />
<label for="ltdc_sts-yes">Applicable</label>
</div>
</div>
</div>
<div class="col-md-12 ltdc_data_div mb-3 pl-4" style="display: none;">
<div class="row">
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Tax Rate <span class="ltdc_required"></span></label>
<select class="form-control" name="tax_rate" id="tax_rate">
<option value="">--Select--</option>
<option value=" 0.1"> 0.1</option>
<option value="0.15">0.15</option>
<option value="0.25">0.25</option>
<option value="0.3">0.3</option>
<option value="0.36">0.36</option>
<option value="0.4">0.4</option>
<option value="0.5">0.5</option>
<option value="0.75">0.75</option>
<option value="0.9">0.9</option>
<option value="1">1</option>
<option value="1.02">1.02</option>
<option value="1.5">1.5</option>
<option value="1.6">1.6</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="10">10</option>
<option value="10.3">10.3</option>
<option value="10.4">10.4</option>
<option value="20">20</option>
<option value="30.9">30.9</option>
</select>
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">LTDC Date <span class="ltdc_required"></span></label>
<input class="form-control date_formating" type="text" id="ltdc_start_date" value="" readonly autocomplete='off' name="ltdc_start_date" placeholder="Enter LTDC Date">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">LTDC Doc <span class="ltdc_required"></span></label>
<input type="file" class="form-control form26as_document_name document_check" id="ltdc_doc" name="ltdc_doc" />
</div>
</div>
</div>
</div>--->
<!-- <div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">MSMED End Date </label>
<input class="form-control date_formating" type="text" id="msmed_end_date" value="" readonly autocomplete='off' name="msmed_end_date" placeholder="Enter MSMED End Date">
</div>
</div> -->
<div class="col-md-4">
<!-- <div class="form-group">
<label class="control-label RobotoMedium">MSMED End Date </label>
<input class="form-control date_formating" type="text" id="msmed_end_date" value="" readonly autocomplete='off' name="msmed_end_date" placeholder="Enter MSMED End Date">
</div> -->
</div>
<div class="col-md-4">
<!-- <div class="form-group">
<label class="control-label RobotoMedium">MSMED End Date </label>
<input class="form-control date_formating" type="text" id="msmed_end_date" value="" readonly autocomplete='off' name="msmed_end_date" placeholder="Enter MSMED End Date">
</div> -->
</div>
</div>
<div class="col-md-12">
</div>
<div class="row rcm_div">
<div class="col-md-12 mt-2">
<div class="form-group">
<!-- <label class="control-label RobotoMedium">
MSMED Status
</label> -->
<h5 class="tile-title vendor-title">Reverse Charge Mechanism (in GST) :</h5>
<div class="switch-field">
<input type="radio" value="Not Applicable" id="rcm_sts-no" class="rcm_sts" name="rcm_sts" checked="">
<label for="rcm_sts-no">Not Applicable </label>
<input type="radio" value="Applicable" id="rcm_sts-yes" class="rcm_sts" name="rcm_sts">
<label for="rcm_sts-yes">Applicable</label>
</div>
</div>
</div>
<!--<div class="col-md-12 rcm_data_div mb-3 pl-4" style="display: none;">
<div class="row">
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Applicable <span class="rcm_required"></span></label>
<select class="form-control" name="tax_rate" id="tax_rate">
<option value="">--Select--</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select>
</div>
</div>
</div>
</div>-->
</div>
<div class="row bank_details">
<div class="col-md-12 mt-4">
<div class="form-group">
<h5 class="tile-title vendor-title">Bank Details :</h5>
</div>
</div>
<div class="col-md-12 bank-table-container">
<!-- <label class="control-label RobotoMedium">Bank Details *</label> -->
<!-- <div class="form-group row "> -->
<!-- <div class="col-sm-12 bank-table-container"> -->
<div class="table-responsive">
<table class="table">
<thead>
<tr>
<th class="" style="display: none;">Default</th>
<th width="200px">Bank Name*</th>
<th class="other_bank_td" style="display: none;">Other Bank Name*</th>
<th>Account Name*</th>
<th style="display: none;" class="other_bank_name_class">Other Account Name*</th>
<th>Account No*</th>
<th>Bank Branch </th>
<th>Bank Address* </th>
<th width="120px" class="th_bank_ifsc">IFSC*</th>
<th></th>
</tr>
</thead>
<tbody>
<tr class="input-data-row row_bank tr_bank1" data-div_id="1">
<td class="" style="display: none;">
<div class="form-check">
<input class="form-check-input bank_radio" type="radio" name="is_default_bank[1]" checked="">
</div>
<i class="desc-tip">Select Default</i>
</td>
<td class="">
<!-- <input type="text" class="form-control bank_name" value="" placeholder="Enter Bank Name" name="bank_name[1]" />
<i class="desc-tip">Enter Bank Name</i> -->
<div class="col-md-12">
<div class="form-group">
<select class="form-control select-width-fix bank_name select2-hidden-accessible" name="bank_name" data-select2-id="8" tabindex="-1" aria-hidden="true">
<option value="" data-select2-id="10">--Select--</option>
<option value="95">AB Bank Ltd.</option>
<option value="124">Abu Dhabi Commercial Bank Ltd.</option>
<option value="131">American Express Banking Corporation</option>
<option value="50">Andhra Pradesh Grameena Vikas Bank</option>
<option value="49">Andhra Pragathi Grameena Bank</option>
<option value="51">Arunachal Pradesh Rural Bank</option>
<option value="52">Aryavart Bank</option>
<option value="53">Assam Gramin Vikash Bank</option>
<option value="35">Au Small Finance Bank Limited</option>
<option value="92">Australia and New Zealand Banking Group Ltd.</option>
<option value="13">Axis Bank Ltd.</option>
<option value="14">Bandhan Bank Ltd.</option>
<option value="54">Bangiya Gramin Vikas Bank</option>
<option value="132">Bank of America</option>
<option value="94">Bank of Bahrain & Kuwait BSC</option>
<option value="1">Bank of Baroda</option>
<option value="120">Bank of Ceylon</option>
<option value="137">Bank of China Ltd.</option>
<option value="2">Bank of India</option>
<option value="3">Bank of Maharashtra</option>
<option value="97">Bank of Nova Scotia</option>
<option value="128">Barclays Bank Plc.</option>
<option value="55">Baroda Gujarat Gramin Bank</option>
<option value="56">Baroda Rajasthan Kshetriya Gramin Bank</option>
<option value="57">Baroda UP Bank</option>
<option value="99">BNP Paribas</option>
<option value="4">Canara Bank</option>
<option value="36">Capital Small Finance Bank Limited</option>
<option value="5">Central Bank of India</option>
<option value="58">Chaitanya Godavari Grameena Bank</option>
<option value="59">Chhattisgarh Rajya Gramin Bank</option>
<option value="133">Citibank N.A.</option>
<option value="16">City Union Bank Ltd.</option>
<option value="108">Cooperatieve Rabobank U.A.</option>
<option value="100">Credit Agricole Corporate & Investment Bank</option>
<option value="121">Credit Suisse A.G</option>
<option value="15">CSB Bank Ltd.</option>
<option value="122">CTBC Bank Co., Ltd.</option>
<option value="60">Dakshin Bihar Gramin Bank</option>
<option value="136">DBS Bank India Limited*</option>
<option value="17">DCB Bank Ltd.</option>
<option value="102">Deutsche Bank</option>
<option value="18">Dhanlaxmi Bank Ltd.</option>
<option value="109">Doha Bank</option>
<option value="61">Ellaquai Dehati Bank</option>
<option value="127">Emirates Bank NBD</option>
<option value="37">Equitas Small Finance Bank Limited</option>
<option value="41">ESAF Small Finance Bank Limited</option>
<option value="19">Federal Bank Ltd.</option>
<option value="42">Fincare Small Finance Bank Limited</option>
<option value="47">Fino Payments Bank Limited</option>
<option value="126">First Abu Dhabi Bank PJSC</option>
<option value="114">FirstRand Bank Ltd</option>
<option value="139">GI Technology Private Limited</option>
<option value="20">HDFC Bank Ltd</option>
<option value="62">Himachal Pradesh Gramin Bank</option>
<option value="103">HSBC Ltd</option>
<option value="21">ICICI Bank Ltd.</option>
<option value="34">IDBI Bank Ltd.</option>
<option value="23">IDFC First Bank Ltd.</option>
<option value="46">India Post Payments Bank Limited</option>
<option value="6">Indian Bank</option>
<option value="7">Indian Overseas Bank</option>
<option value="22">Induslnd Bank Ltd</option>
<option value="98">Industrial & Commercial Bank of China Ltd.</option>
<option value="118">Industrial Bank of Korea</option>
<option value="63">J&K Grameen Bank</option>
<option value="134">J.P. Morgan Chase Bank N.A.</option>
<option value="24">Jammu & Kashmir Bank Ltd.</option>
<option value="43">Jana Small Finance Bank Limited</option>
<option value="142">Janata Sahakari Bank, Ajara</option>
<option value="64">Jharkhand Rajya Gramin Bank</option>
<option value="111">JSC VTB Bank</option>
<option value="25">Karnataka Bank Ltd.</option>
<option value="65">Karnataka Gramin Bank</option>
<option value="66">Karnataka Vikas Grameena Bank</option>
<option value="26">Karur Vysya Bank Ltd.</option>
<option value="117">KEB Hana Bank</option>
<option value="67">Kerala Gramin Bank</option>
<option value="119">Kookmin Bank</option>
<option value="27">Kotak Mahindra Bank Ltd</option>
<option value="123">Krung Thai Bank Public Co. Ltd.</option>
<option value="28">Lakshmi Vilas Bank Ltd.</option>
<option value="68">Madhya Pradesh Gramin Bank</option>
<option value="69">Madhyanchal Gramin Bank</option>
<option value="70">Maharashtra Gramin Bank</option>
<option value="71">Manipur Rural Bank</option>
<option value="125">Mashreq Bank PSC</option>
<option value="72">Meghalaya Rural Bank</option>
<option value="73">Mizoram Rural Bank</option>
<option value="143">Mizoram Urban Development co-op Bank</option>
<option value="105">Mizuho Bank Ltd.</option>
<option value="107">MUFG Bank, Ltd.</option>
<option value="74">Nagaland Rural Bank</option>
<option value="29">Nainital Bank Ltd.</option>
<option value="130">NatWest Markets Plc</option>
<option value="44">North East Small Finance Bank Limited</option>
<option value="75">Odisha Gramya Bank</option>
<option value="76">Paschim Banga Gramin Bank</option>
<option value="48">Paytm Payments Bank Limited</option>
<option value="77">Prathama UP Gramin Bank</option>
<option value="104">PT Bank Maybank Indonesia TBK</option>
<option value="78">Puduvai Bharathiar Grama Bank</option>
<option value="8">Punjab & Sind Bank</option>
<option value="79">Punjab Gramin Bank</option>
<option value="9">Punjab National Bank</option>
<option value="110">Qatar National Bank</option>
<option value="80">Rajasthan Marudhara Gramin Bank</option>
<option value="141">Rajkot Nagarik Sahakari Bank Ltd.</option>
<option value="30">RBL Bank Ltd.</option>
<option value="81">Saptagiri Grameena Bank</option>
<option value="82">Sarva Haryana Gramin Bank</option>
<option value="83">Saurashtra Gramin Bank</option>
<option value="112">Sberbank</option>
<option value="135">SBM Bank (India) Limited*</option>
<option value="115">Shinhan Bank</option>
<option value="45">Shivalik Small Finance Bank Limited</option>
<option value="101">Societe Generale</option>
<option value="96">Sonali Bank Ltd.</option>
<option value="31">South Indian Bank Ltd.</option>
<option value="129">Standard Chartered Bank</option>
<option value="10">State Bank of India</option>
<option value="106">Sumitomo Mitsui Banking Corporation</option>
<option value="38">Suryoday Small Finance Bank Limited</option>
<option value="140">SVC Co-operative Bank Ltd</option>
<option value="84">Tamil Nadu Grama Bank</option>
<option value="32">Tamilnad Mercantile Bank Ltd.</option>
<option value="85">Telangana Grameena Bank</option>
<option value="138">TJSB Sahakari Bank Ltd</option>
<option value="86">Tripura Gramin Bank</option>
<option value="11">UCO Bank</option>
<option value="39">Ujjivan Small Finance Bank Limited</option>
<option value="12">Union Bank of India</option>
<option value="113">United Overseas Bank Ltd</option>
<option value="87">Utkal Grameen bank</option>
<option value="40">Utkarsh Small Finance Bank Limited</option>
<option value="88">Uttar Bihar Gramin Bank</option>
<option value="89">Uttarakhand Gramin Bank</option>
<option value="90">Uttarbanga Kshetriya Gramin Bank</option>
<option value="91">Vidharbha Konkan Gramin Bank</option>
<option value="93">Westpac Banking Corporation</option>
<option value="116">Woori Bank</option>
<option value="33">YES Bank Ltd.</option>
<option value="other">Other</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="9" style="width: 146px;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-bank_name-lz-container"><span class="select2-selection__rendered" id="select2-bank_name-lz-container" role="textbox"
aria-readonly="true" title="--Select--">--Select--</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper"
aria-hidden="true"></span></span>
</div>
</div>
</td>
<td class="other_bank_td" style="display: none;">
<input type="text" class="form-control desc-input tb-input other_bank" placeholder="Enter Other Bank Name" name="other_bank">
<i class="desc-tip">Enter Other Bank Name</i>
</td>
<td class="" width="150px">
<div style="display: none" id="trade_legal_name_dropdonlist_bank">
<select class="form-control select-width-fix required select2-hidden-accessible" id="trade_legal_name_bank" name="trade_legal_name_bank" data-select2-id="trade_legal_name_bank" tabindex="-1" aria-hidden="true"
aria-required="true">
<option value="" data-select2-id="12">-Select-</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="11" style="width: auto;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-trade_legal_name_bank-container"><span class="select2-selection__rendered" id="select2-trade_legal_name_bank-container"
role="textbox" aria-readonly="true" title="-Select-">-Select-</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper"
aria-hidden="true"></span></span>
</div>
<input type="text" class="form-control desc-input tb-input bank_acc_name" autocomplete="off" placeholder="Enter Account Name." name="bank_acc_name">
<i class="desc-tip">Enter Account Name</i>
</td>
<td style="display: none;" class="other_bank_name_class">
<input type="text" class="form-control other_bank_required" autocomplete="off" placeholder="Other Account Name" name="other_account_name" id="other_account_name">
<i class="desc-tip">Other Account Name</i>
</td>
<td class="">
<input type="text" class="form-control desc-input tb-input bank_acc_no" autocomplete="off" placeholder="Enter Account No." name="bank_acc_no">
<i class="desc-tip">Enter Account No.</i>
</td>
<td class="">
<input type="text" class="form-control only-numeric bank_branch" value="" autocomplete="off" placeholder="Enter Bank Branch" name="bank_branch">
<i class="desc-tip">Enter Bank Branch</i>
</td>
<td>
<input type="text" class="form-control desc-input tb-input bank_address" autocomplete="off" placeholder="Enter Bank Address" name="bank_addr">
<i class="desc-tip">Enter Bank Address</i>
</td>
<td>
<input type="text" class="form-control desc-input tb-input bank_ifsc" autocomplete="off" placeholder="Enter IFSC" name="bank_ifsc">
<i class="desc-tip">Enter IFSC/Swift Code</i>
</td>
<td>
<a href="javascript:void(0)" class="trash-bank" style="display: none;"><i class="fa fa-trash" aria-hidden="true"></i></a>
</td>
</tr>
<!-- <tr class="bank-calculation">
<td colspan="13" class="add-item">
<div><a href="javascript:void(0)" class="add-bank-link"> + Add bank</a></div>
<i style="font-size: 10px;">Maximum 5 rows can be added</i>
</td>
</tr> -->
</tbody>
</table>
<!--<table class="table col-md-6" >
<thead>
<tr>
<th width=200px>Other Account Name*</th>
<th width=200px>Bank Letter/Other*</th>
</tr>
</thead>
<tbody>
<tr class="input-data-row">
<td class="">
<input type="text" class="form-control " value="" autocomplete="off" placeholder="Other Account Name" name="other_bank_name" />
<i class="desc-tip">Other Account Name</i>
</td>
<td class="">
<input type="file" class="form-control " value="" autocomplete="off" placeholder="Upload Bank Docs" name="other_bank_doc" />
<i class="desc-tip">Bank Letter/Other </i>
</td>
</tr>
</tbody>
</table>--->
</div>
</div>
</div>
<div class="row col-md-12">
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium" id="bank_letter_text">Bank Letter/Other</label>
<input type="file" class="form-control " autocomplete="off" placeholder="Upload Bank Docs" id="other_bank_doc" name="other_bank_doc">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label class="control-label RobotoMedium">Cancelled Cheque*</label>
<input type="file" class="form-control document_check" name="bank_letter" placeholder="Name & Account number should be clearly visible on documentation.">
</div>
</div>
</div>
<div class="col-md-12 mt-5">
<input type="hidden" id="declaration_msg" name="declaration_msg">
<label class="control-label RobotoMedium" for="declaration_msg">
<input type="checkbox" class="declaration_msg_check" name="declaration_msg_check">
<span class="declaration_msg_text_capture RobotoMedium control-label"> I certify that the information furnished above is correct and complete to the best of my knowledge and belief. I also undertake to inform the company of any subsequent
changes in the above particulars from time to time. </span>
</label>
</div>
<div class="col-md-12 mt-3">
<label class="control-label RobotoMedium"> The above information is meant only for our records and will not be used for any other purposes. In case the information is found incorrect, the Company reserves the right to cancel the registration
and take any other action as deemed fit. <br><br><input type="checkbox" class="declaration_msg_check" name="declaration_msg_check2"> You acknowledge and unconditionally accept that:<br>
</label>
<label class="control-label RobotoMedium">
<!--The above information is meant only for our records and will not be used for any other purposes. In case the information is found incorrect, the Company reserves the right to cancel the registration and take any other action as deemed fit.-->
<ol>
<li> You are/will be fully compliant with the Law of Land.</li>
<li>While providing services to us, you, your agents, or your employees will not engage in any illegal activity, including but not limited to Bribery, Undue Gifting, and/or favours to any government officials or regulators and shall not
indulge in any malpractices while dealing with any other private party too.</li>
<li>If you, your agents, or your employees are found to have engaged in any of the above activities, any open contracts shall be liable for immediate cancellation and you along with your partner shall be responsible for any legal action,
penalties, and any consequential losses, including the reputational loss which the Group may face.</li>
<li> In case you find any such undue favour being demanded by any of the Girnar Group officials or its employees, you shall promptly report the same to <a href="mailto:speakup@girnarsoft.com" style="color:blue;">speakup@girnarsoft.com</a>
</li>
<li> You have read the <a target="_blank" style="color:blue;" href="https://careline.girnarsoft.com/upload/common-policy/Anti-Bribery%20&%20Anti-Corruption%20Policy_1431955160.pdf">Anti-Bribery/Anti-Corruption (“ABC”) Policy</a> of
Girnar Group and confirm that you understand the Group Policy.</li>
</ol>
</label>
</div>
</div>
<input type="hidden" id="vendor_id" value="">
<div class="col-md-12">
<div class="submit-btn-box">
<input type="hidden" name="user_agent" value="Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/111.0.5563.64 Safari/537.36">
<input type="hidden" name="user_id" value="2353">
<input type="hidden" name="vendor_token_id" id="vendor_token_id" value="940">
<input type="hidden" name="entities" id="entities" value="GCAP">
<input type="button" id="vendor-submit" class="btn btn-primary btn-submit" onclick="$(this).submit();" value="SUBMIT">
<input type="hidden" class="" value="No" name="girnar_employee_response" id="girnar_employee_response">
<input type="hidden" class="tradeName" value="">
<input type="hidden" class="" value="" id="form_filled_by" name="form_filled_by">
<input type="hidden" class="" value="" id="get_reason_for_form_filling" name="get_reason_for_form_filling">
<input type="hidden" class="" value="" name="account_name_type" id="account_name_type">
<input type="hidden" name="getEentity" value="Girnar Capital Pvt. Ltd.">
<!--<input type="button" class="btn btn-primary btn-cancel" value="CANCEL" />-->
<div id="addCheckedGstdata" style="visibility: hidden;">
</div>
</div>
</div>
</form>Name: user_form — POST
<form role="form" id="user_form" name="user_form" method="post" style="width: 89%;" novalidate="novalidate">
<div class="modal-body">
<div class="form-group row pl-3 ">
<h5 class="tile-title vendor-title col-md-10 col-form-label">
<!--Are you an employee filling this form on the behalf of vendor? --> Are you a Girnar employee filling the form on behalf of vendor?
</h5>
<br>
<div class="col-md-2">
<div class="switch-field">
<input type="radio" value="No" data-status="1" id="user_sts-no" class="user_sts" name="user_sts" checked="">
<label for="user_sts-no">No </label>
<input type="radio" value="Yes" data-status="" id="user_sts-yes" class="user_sts" name="user_sts">
<label for="user_sts-yes">Yes</label>
</div>
</div>
</div>
<div class="row user_details" style="display: none;">
<!--<div class="col-md-12" >
<p align="left" style="margin-left: 18px;" class="emp_text">Girnar employees can submit vendor registration for group entities only. </p>
</div>--->
<div class="col-md-12">
<!-- <p align="center" class="emp_text">Girnar employees can submit vendor registration for group entities only. </p>--->
<div class="col-md-12">
<div class="form-group row pl-3">
<label class="control-label RobotoMedium col-md-9 col-form-label"> Please Select your Email ID *</label>
<div class="col-md-9">
<select class="form-control select-width-fix select2-hidden-accessible" name="employee_code" id="employee_code" data-select2-id="employee_code" tabindex="-1" aria-hidden="true">
<option value="" data-select2-id="23">-Select-</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="22" style="width: auto;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-employee_code-container"><span class="select2-selection__rendered" id="select2-employee_code-container" role="textbox"
aria-readonly="true" title="-Select-">-Select-</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
</div>
</div>
<div class="col-md-12">
<div class="form-group row pl-3">
<label class="control-label RobotoMedium col-md-9 col-form-label">Please Select the reason for filling on behalf of vendor *</label>
<div class="col-md-9">
<select class="form-control select-width-fix reason_for_form_filling select2-hidden-accessible" id="reason_for_form_filling" name="reason_for_form_filling" data-select2-id="reason_for_form_filling" tabindex="-1" aria-hidden="true">
<option value="" data-select2-id="21">--Select--</option>
<option value="Inter-company Vendor">Inter-company Vendor</option>
<option value="Vendor is Govt. Agency">Vendor is Govt. Agency</option>
<option value="Business Need">Business Need</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="20" style="width: auto;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-reason_for_form_filling-container"><span class="select2-selection__rendered" id="select2-reason_for_form_filling-container"
role="textbox" aria-readonly="true" title="--Select--">--Select--</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper"
aria-hidden="true"></span></span>
</div>
</div>
</div>
</div>
</div>
<div class="modal-footer">
<div class="form-group center action-form-button-div">
<div id="resend_otp_timer"></div>
<a href="javascript:void(0);" id="" class="modal-submit for_Girnar_emp" onclick="$(this).submit();">Continue</a>
</div>
</div>
</div>
</form>Name: otp_form — POST
<form role="form" id="otp_form" name="otp_form" method="post" novalidate="novalidate">
<input type="hidden" name="window" value="">
<input type="hidden" name="billing_entity_name" id="billing_entity_name" value="">
<input type="hidden" name="billing_entity_alias" id="billing_entity_alias" value="">
<input type="hidden" name="mobile_no" id="mobile_no">
<input type="hidden" name="email_valid" id="email_valid">
<input type="hidden" name="action" value="validate_vendor_otp">
<div class="modal-header">
<h4 class="modal-title RobotoMedium">OTP Verification</h4>
</div>
<!-- <div class="modal-body">
<div class="modal-body"> -->
<div class="modal-body">
<div class="row otp_msg_box">
<div class="col-md-12">
<img src="https://fincare.girnarsoft.co.in/images/access.png" alt="access">
<label class="control-label RobotoMedium alert alert-success"> Your information has been submitted successfully </label>
<!--<a href="javascript:void(0);" id="close-window" class="modal-submit" onclick="" >Close</a>-->
<!--<a href="javascript:void(0);" class="modal-submit pull-right" id="btnclose">Close</a>-->
</div>
<!-- </div> -->
<!-- </div> -->
</div>
<div class="form-group GAPL_fmg otp_box">
<label class="control-label RobotoMedium"> You will receive an OTP in your offical mobile number ( <i><span id="authorised_person_mobile_text_for_otp"></span></i> ), request you to please insert it here. </label>
<input type="text" value="" autocomplete="off" name="otp_mob" id="otp_mob" maxlength="4" oninput="this.value = this.value.replace(/[^0-9]/g,'');"> <sapn style="display: none;" class="resend_otp_timer" id="resend_otp_timer_mob">
</sapn>
<a href="javascript:void(0);" class="otp_resend" id="otp_resend_mob">Resend Mobile OTP</a>
</div>
<br>
<div class="form-group GAPL_fmg otp_box">
<label class="control-label RobotoMedium"> You will receive an OTP in your offical email ( <i><span id="authorised_person_email_text_for_otp"></span></i> ), request you to please insert it here. </label>
<input type="text" value="" autocomplete="off" name="otp_email" id="otp_email" maxlength="4" oninput="this.value = this.value.replace(/[^0-9]/g,'');"> <sapn style="display: none;" class="resend_otp_timer"
id="resend_otp_timer_email"></sapn>
<a href="javascript:void(0);" class="otp_resend" id="otp_resend_email">Resend Email OTP</a>
</div>
<div class="modal-footer">
<div class="form-group center action-form-button-div">
<div id="resend_otp_timer"></div>
<a href="javascript:void(0);" id="close_otp_popup">CLOSE</a> <a href="javascript:void(0);" id="otp_submit" class="modal-submit" onclick="$(this).submit();">Verify</a>
<input type="hidden" name="funcName" value="verifyOTP">
<input type="hidden" id="getToken" name="getToken" value="MjM1MzoyMDIzLTAzLTIzOjYzZjcxNDA3NmE1YTg6IEdDQVA6IENyZWF0ZV9WZW5kb3I">
<input type="hidden" id="getEentity" name="getEentity" value="Girnar Capital Pvt. Ltd.">
</div>
</div>
</div>
</form>Text Content
GENERAL DETAILS :
Are you, i.e. the vendor not registered in India?
YES NO
GSTIN Registration Status * --Select-- Registered Composite SEZ Unregistered
--Select--
GSTIN
State of Supply * Select Andaman & Nicobar Islands | AN | 35Andhra Pradesh | AP
| 37Arunachal Pradesh | AR | 12Assam | AS | 18Bihar | BR | 10Chandigarh | CH |
04Chhattishgarh | CG | 22Dadra & Nagar Haveli | DN | 26Daman & Diu | DD |
25Delhi | DL | 07Goa | GA | 30Gujarat | GJ | 24Haryana | HR | 06Himachal Pradesh
| HP | 02Jammu & Kashmir | JK | 01Jharkhand | JH | 20Karnataka | KA | 29Kerala |
KL | 32Lakhswadeep | LD | 31Madhya Pradesh | MP | 23Maharashtra | MH | 27Manipur
| MN | 14Meghalaya | ML | 17Mizoram | MZ | 15Nagaland | NL | 13Orissa | OR |
21Pondicherry | PY | 34Punjab | PB | 03Rajasthan | RJ | 08Sikkim | SK |
11Tamilnadu | TN | 33Telangana | TS | 36Tripura | TR | 16Uttar Pradesh | UP |
09Uttarakhand | UK | 05West Bengal | WB | 19International | | Select
GSTIN *
--Select-- --Select--
GSTIN Registration Doc *
GSTIN ADDRESS DETAILS *
Principal Place of Business
Default Address 1 Address 2 City Pincode
Select Default Address 1 Address 2 City Enter Pincode/Zipcode Enter State Enter
Country
Additional Place of Business
Select Default Address 1 Address 2 City Enter Pincode/Zipcode Enter State Enter
Country
+ Add GSTIN
Vendor Name (Select/Enter name which will appear on invoices submitted to Girnar
Group)*
-Select- PT CSI Indonesia Carbay PTE Ltd Carbay Philippines Inc CARBAY SERVICES
MALAYSIA SDN. BHD. -Select-
-Select- -Select-
Vendor Mobile No (for OTP verification) *
Vendor Email (for OTP verification) *
Business Entity Type * --Select-- Limited Liability Partnership (LLP)
Limited/Private Limited/OPC Individual/Proprietorship Hindu Undivided Family
(HUF) --Select--
Business Doc (The incorporation/business certificate/trade license)
Other Business Entity Type *
CONTACT PERSON DETAILS :
Title * --Select-- Mr. Ms. --Select--
First Name *
Last Name *
Mobile No *
Alternate Mobile No
Email *
Finance Dept’s email id *
TAX DETAILS :
Not Applicable Applicable
Tax ID Number *
Tax ID Number Doc *
ADDRESS DETAILS :
Default Address 1* Address 2 City* Country* State * Pincode*
Select Default Enter Address1 Enter Address2 Enter City
--Select-- Afghanistan Aland Islands Albania Algeria American Samoa Andorra
Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia
Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize
Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and
Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei
Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde
Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos
(Keeling) Islands Colombia Comoros Congo Congo, Democratic Republic of the Congo
Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Curacao Cyprus Czech Republic
Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador
Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe
Islands Fiji Finland France French Guiana French Polynesia French Southern
Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland
Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti
Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong
Kong Hungary Iceland Indonesia Iran, Islamic Republic of Iraq Ireland Isle of
Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea,
Democratic People's Republic of Korea, Republic of Kosovo Kuwait Kyrgyzstan Lao
People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab
Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, the Former
Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall
Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated
States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco
Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New
Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern
Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied
Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal
Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthelemy
Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and
Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe
Saudi Arabia Senegal Serbia Serbia and Montenegro Seychelles Sierra Leone
Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa
South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan
Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab
Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of
Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey
Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates
United Kingdom United States United States Minor Outlying Islands Uruguay
Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands,
U.s. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
--Select-- India
Enter Country Enter Province/State --Select-- Andaman & Nicobar Islands Andhra
Pradesh Arunachal Pradesh Assam Bihar Chhattishgarh Chandigarh Daman & Diu Delhi
Dadra & Nagar Haveli Goa Gujarat Himachal Pradesh Haryana Jharkhand Jammu &
Kashmir Karnataka Kerala Lakhswadeep Maharashtra Meghalaya Manipur Madhya
Pradesh Mizoram Nagaland Orissa Punjab Pondicherry Rajasthan Sikkim Tamilnadu
Tripura Telangana Uttarakhand Uttar Pradesh West Bengal Enter Province/State
Enter Pincode/Zipcode
PAN DETAILS :
PAN *
PAN Image *
E INVOICE STATUS :
Not Applicable Applicable
E-Invoice effective date
MSME STATUS :
Not Applicable Applicable
MSME No.
MSME Date
MSME Doc
REVERSE CHARGE MECHANISM (IN GST) :
Not Applicable Applicable
BANK DETAILS :
Default Bank Name* Other Bank Name* Account Name* Other Account Name* Account
No* Bank Branch Bank Address* IFSC*
Select Default
--Select-- AB Bank Ltd. Abu Dhabi Commercial Bank Ltd. American Express Banking
Corporation Andhra Pradesh Grameena Vikas Bank Andhra Pragathi Grameena Bank
Arunachal Pradesh Rural Bank Aryavart Bank Assam Gramin Vikash Bank Au Small
Finance Bank Limited Australia and New Zealand Banking Group Ltd. Axis Bank Ltd.
Bandhan Bank Ltd. Bangiya Gramin Vikas Bank Bank of America Bank of Bahrain &
Kuwait BSC Bank of Baroda Bank of Ceylon Bank of China Ltd. Bank of India Bank
of Maharashtra Bank of Nova Scotia Barclays Bank Plc. Baroda Gujarat Gramin Bank
Baroda Rajasthan Kshetriya Gramin Bank Baroda UP Bank BNP Paribas Canara Bank
Capital Small Finance Bank Limited Central Bank of India Chaitanya Godavari
Grameena Bank Chhattisgarh Rajya Gramin Bank Citibank N.A. City Union Bank Ltd.
Cooperatieve Rabobank U.A. Credit Agricole Corporate & Investment Bank Credit
Suisse A.G CSB Bank Ltd. CTBC Bank Co., Ltd. Dakshin Bihar Gramin Bank DBS Bank
India Limited* DCB Bank Ltd. Deutsche Bank Dhanlaxmi Bank Ltd. Doha Bank
Ellaquai Dehati Bank Emirates Bank NBD Equitas Small Finance Bank Limited ESAF
Small Finance Bank Limited Federal Bank Ltd. Fincare Small Finance Bank Limited
Fino Payments Bank Limited First Abu Dhabi Bank PJSC FirstRand Bank Ltd GI
Technology Private Limited HDFC Bank Ltd Himachal Pradesh Gramin Bank HSBC Ltd
ICICI Bank Ltd. IDBI Bank Ltd. IDFC First Bank Ltd. India Post Payments Bank
Limited Indian Bank Indian Overseas Bank Induslnd Bank Ltd Industrial &
Commercial Bank of China Ltd. Industrial Bank of Korea J&K Grameen Bank J.P.
Morgan Chase Bank N.A. Jammu & Kashmir Bank Ltd. Jana Small Finance Bank Limited
Janata Sahakari Bank, Ajara Jharkhand Rajya Gramin Bank JSC VTB Bank Karnataka
Bank Ltd. Karnataka Gramin Bank Karnataka Vikas Grameena Bank Karur Vysya Bank
Ltd. KEB Hana Bank Kerala Gramin Bank Kookmin Bank Kotak Mahindra Bank Ltd Krung
Thai Bank Public Co. Ltd. Lakshmi Vilas Bank Ltd. Madhya Pradesh Gramin Bank
Madhyanchal Gramin Bank Maharashtra Gramin Bank Manipur Rural Bank Mashreq Bank
PSC Meghalaya Rural Bank Mizoram Rural Bank Mizoram Urban Development co-op Bank
Mizuho Bank Ltd. MUFG Bank, Ltd. Nagaland Rural Bank Nainital Bank Ltd. NatWest
Markets Plc North East Small Finance Bank Limited Odisha Gramya Bank Paschim
Banga Gramin Bank Paytm Payments Bank Limited Prathama UP Gramin Bank PT Bank
Maybank Indonesia TBK Puduvai Bharathiar Grama Bank Punjab & Sind Bank Punjab
Gramin Bank Punjab National Bank Qatar National Bank Rajasthan Marudhara Gramin
Bank Rajkot Nagarik Sahakari Bank Ltd. RBL Bank Ltd. Saptagiri Grameena Bank
Sarva Haryana Gramin Bank Saurashtra Gramin Bank Sberbank SBM Bank (India)
Limited* Shinhan Bank Shivalik Small Finance Bank Limited Societe Generale
Sonali Bank Ltd. South Indian Bank Ltd. Standard Chartered Bank State Bank of
India Sumitomo Mitsui Banking Corporation Suryoday Small Finance Bank Limited
SVC Co-operative Bank Ltd Tamil Nadu Grama Bank Tamilnad Mercantile Bank Ltd.
Telangana Grameena Bank TJSB Sahakari Bank Ltd Tripura Gramin Bank UCO Bank
Ujjivan Small Finance Bank Limited Union Bank of India United Overseas Bank Ltd
Utkal Grameen bank Utkarsh Small Finance Bank Limited Uttar Bihar Gramin Bank
Uttarakhand Gramin Bank Uttarbanga Kshetriya Gramin Bank Vidharbha Konkan Gramin
Bank Westpac Banking Corporation Woori Bank YES Bank Ltd. Other --Select--
Enter Other Bank Name
-Select- -Select-
Enter Account Name Other Account Name Enter Account No. Enter Bank Branch Enter
Bank Address Enter IFSC/Swift Code
Bank Letter/Other
Cancelled Cheque*
I certify that the information furnished above is correct and complete to the
best of my knowledge and belief. I also undertake to inform the company of any
subsequent changes in the above particulars from time to time.
The above information is meant only for our records and will not be used for any
other purposes. In case the information is found incorrect, the Company reserves
the right to cancel the registration and take any other action as deemed fit.
You acknowledge and unconditionally accept that:
1. You are/will be fully compliant with the Law of Land.
2. While providing services to us, you, your agents, or your employees will not
engage in any illegal activity, including but not limited to Bribery, Undue
Gifting, and/or favours to any government officials or regulators and shall
not indulge in any malpractices while dealing with any other private party
too.
3. If you, your agents, or your employees are found to have engaged in any of
the above activities, any open contracts shall be liable for immediate
cancellation and you along with your partner shall be responsible for any
legal action, penalties, and any consequential losses, including the
reputational loss which the Group may face.
4. In case you find any such undue favour being demanded by any of the Girnar
Group officials or its employees, you shall promptly report the same to
speakup@girnarsoft.com
5. You have read the Anti-Bribery/Anti-Corruption (“ABC”) Policy of Girnar
Group and confirm that you understand the Group Policy.
ARE YOU A GIRNAR EMPLOYEE FILLING THE FORM ON BEHALF OF VENDOR?
No Yes
Please Select your Email ID *
-Select- -Select-
Please Select the reason for filling on behalf of vendor *
--Select-- Inter-company Vendor Vendor is Govt. Agency Business Need --Select--
Continue
OTP VERIFICATION
Your information has been submitted successfully
You will receive an OTP in your offical mobile number ( ), request you to please
insert it here. Resend Mobile OTP
You will receive an OTP in your offical email ( ), request you to please insert
it here. Resend Email OTP
CLOSE Verify