www.rbmlpartners.in
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68.178.145.246
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Submitted URL: http://reliancejiobp.com/
Effective URL: https://www.rbmlpartners.in/
Submission: On June 26 via api from IN — Scanned from DE
Effective URL: https://www.rbmlpartners.in/
Submission: On June 26 via api from IN — Scanned from DE
Form analysis 1 forms found in the DOM
POST save-datails
<form method="post" enctype="multipart/form-data" action="save-datails" id="form" novalidate="novalidate">
<input type="hidden" name="_token" value="gEt0L4K3roicEJtgkXUgfWilD2r2wvahLz69yaxC">
<div class="form-group" style="color:red;font-weight:bold;">
<div class="row clearfix">
<div class="form-group col-md-6 col-sm-6 col-xs-12">
<label for="first_name">First Name</label>
<div class="form-group-inner">
<div class="field-outer">
<input type="text" name="first_name" id="first_name" placeholder="First Name" required="">
</div>
</div>
</div>
<div class="form-group col-md-6 col-sm-6 col-xs-12">
<label for="last_name">Last Name</label>
<div class="form-group-inner">
<div class="field-outer">
<input type="text" name="last_name" id="last_name" placeholder="Last Name" required="">
</div>
</div>
</div>
<div class="form-group col-md-4 col-sm-12 col-xs-12">
<label for="email">Email</label>
<div class="form-group-inner">
<div class="field-outer">
<input type="email" name="email" id="email" placeholder="Email ID" required="">
</div>
</div>
</div>
<div class="form-group col-md-4 col-sm-12 col-xs-12">
<label for="password">Password</label>
<div class="form-group-inner">
<div class="field-outer">
<input type="password" name="password" id="password" placeholder="*************" required="">
</div>
</div>
</div>
<div class="form-group col-md-4 col-sm-12 col-xs-12">
<label for="mobileno">Mobile No.</label>
<div class="form-group-inner">
<div class="field-outer">
<input type="text" name="mobileno" id="mobileno" pattern="[6789][0-9]{9}" placeholder="Mobile Number" required="">
</div>
</div>
</div>
<div class="form-group col-md-6 col-sm-12 col-xs-12">
<label for="state">State</label>
<div class="form-group-inner">
<div class="field-outer">
<select id="state" required="" name="state">
<option value="" selected="selected">Select</option>
<option value="1">Andaman and Nicobar Islands</option>
<option value="2">Andhra Pradesh</option>
<option value="3">Arunachal Pradesh</option>
<option value="4">Assam</option>
<option value="5">Bihar</option>
<option value="6">Chandigarh</option>
<option value="7">Chhattisgarh</option>
<option value="8">Dadra and Nagar Haveli</option>
<option value="10">Daman and Diu</option>
<option value="11">Delhi</option>
<option value="12">Goa</option>
<option value="13">Gujarat</option>
<option value="14">Haryana</option>
<option value="15">Himachal Pradesh</option>
<option value="16">Jammu and Kashmir</option>
<option value="17">Jharkhand</option>
<option value="18">Karnataka</option>
<option value="19">Kerala</option>
<option value="20">Lakshadweep</option>
<option value="21">Madhya Pradesh</option>
<option value="22">Maharashtra</option>
<option value="23">Manipur</option>
<option value="24">Meghalaya</option>
<option value="25">Mizoram</option>
<option value="26">Nagaland</option>
<option value="27">Orissa</option>
<option value="28">Puducherry (UT)</option>
<option value="29">Punjab</option>
<option value="30">Rajasthan</option>
<option value="31">Sikkim</option>
<option value="32">Tamil Nadu</option>
<option value="33">Telangana</option>
<option value="34">Tripura</option>
<option value="35">Uttar Pradesh</option>
<option value="36">Uttarakhand</option>
<option value="37">West Bengal</option>
</select>
</div>
</div>
</div>
<div class="form-group col-md-6 col-sm-12 col-xs-12">
<label for="district">District</label>
<div class="form-group-inner">
<div class="field-outer">
<input type="text" name="district" id="district" placeholder="District" required="">
</div>
</div>
</div>
<div class="form-group col-md-12 col-sm-12 col-xs-12">
<label for="address">Proposed Locality Adress/City</label>
<div class="form-group-inner">
<div class="field-outer">
<textarea name="address" id="address" placeholder="Address" required=""></textarea>
</div>
</div>
</div>
<div class="form-group col-md-6 col-sm-12 col-xs-12">
<label for="source_info">Source of Information</label>
<div class="form-group-inner">
<div class="field-outer">
<select class="source_info" id="source_info" required="" name="source_info">
<option value="" selected="selected">Select</option>
<option value="1">Digital Ad</option>
<option value="2">Newspaper Ad</option>
<option value="3">Contacted by Company</option>
</select>
</div>
</div>
</div>
<div class="form-group col-md-6 col-sm-12 col-xs-12">
<label for="current_business">Current Business</label>
<div class="form-group-inner">
<div class="field-outer">
<select id="current_business" required="" name="current_business">
<option value="" selected="selected">Select</option>
<option value="1">Transportation & Logistics</option>
<option value="2">Petroleum Products & Dealership</option>
<option value="3">Real Estate & Housing</option>
<option value="4">Automobile related</option>
<option value="5">Construction</option>
<option value="6">Utilities</option>
<option value="7">Agriculture</option>
<option value="8">Others</option>
<option value="9">Retail</option>
</select>
</div>
</div>
</div>
<div class="form-group col-md-6 col-sm-12 col-xs-12">
<label for="location_category">Location Category</label>
<div class="form-group-inner">
<div class="field-outer">
<select name="location_category" id="location_category" required="">
<option value="">Select</option>
<option value="Rural">Rural</option>
<option value="Urban">Urban</option>
</select>
</div>
</div>
</div>
<div class="form-group col-md-6 col-sm-12 col-xs-12">
<label for="last_year_turn_over">Last Year Turn Over</label>
<div class="form-group-inner">
<div class="field-outer">
<input type="text" name="last_year_turn_over" id="last_year_turn_over" placeholder="Last Year Turnover" required="">
</div>
</div>
</div>
<div class="form-group col-md-6 col-sm-12 col-xs-12">
<label for="plot_length">Plot Length (in Meters)</label>
<div class="form-group-inner">
<div class="field-outer">
<input type="text" name="plot_length" id="plot_length" placeholder="Plot Length" required="">
</div>
</div>
</div>
<div class="form-group col-md-6 col-sm-12 col-xs-12">
<label for="plot_breath">Plot Breath (in Meters)</label>
<div class="form-group-inner">
<div class="field-outer">
<input type="text" name="plot_breath" id="plot_breath" placeholder="Plot Breath" required="">
</div>
</div>
</div>
<div class="form-group col-md-6 col-sm-12 col-xs-12">
<label for="caste_category">Caste Category</label>
<div class="form-group-inner">
<div class="field-outer">
<select name="caste_category" id="caste_category" required="">
<option value="">Select</option>
<option value="1">General</option>
<option value="2">OBC</option>
<option value="3">SC/ST</option>
</select>
</div>
</div>
</div>
<div class="form-group col-md-6 col-sm-12 col-xs-12">
<label for="amount">Amount</label>
<div class="form-group-inner">
<div class="field-outer">
<span id="faramount">0</span>
<input type="hidden" name="amount" id="amount" value="0" required="">
</div>
</div>
</div>
<div class="form-group col-md-12 col-sm-12 col-xs-12">
<!-- <label for="security_code">Enter the code here*</label> -->
<div class="form-group-inner" style="border: none;">
<div class="field-outer">
<div class="col-md-5 col-sm-5 col-xs-12">
<span class="captcha"><img src="https://www.rbmlpartners.in/captcha/flat?h37xW5wK"></span>
<span><button type="button" class="refresh-captcha btn btn-success btn-refresh"><i class="fa fa-refresh"></i></button> </span>
</div>
<div class="col-md-7 col-sm-7 col-xs-12">
<input id="captcha" name="security_code" type="text" class="form-control" maxlength="6" required="">
<span class="error" id="captcha-error" style="font-size:10px; display:none">Invalid Captcha</span>
</div>
</div>
</div>
</div>
<div class="form-group col-md-12 col-sm-12 col-xs-12 ">
<button class="hvr-bounce-to-right" id="proceed" type="submit">Proceed</button>
</div>
</div>
<div>
<hr>
<h4 style="margin-bottom: 10px;">Disclaimer</h4>
<ul>
<li>Submission of the information by you does not guarantee any commitment by the company.</li>
<li>Company reserves the right to reject any application at its sole discretion without assigning any reason or intimation.</li>
<li>We do not have any agents to facilitate Channel Partner appointments, kindly do not deal with any third party who assure grant of dealership etc. to you.<br><br><br> </li>
</ul>
</div>
</div>
</form>Text Content
PARTNERS IN PROGRESS LAST DATE FOR APPLICATION FOR RETAIL FUEL STATION ⛽. ....APPLY NOW. CALL NOW 18005724744 Requirement for Prospective Dealership: * If you share our pioneering spirit and are fuelled by the passion to grow and have resources to invest, then express your interest by filling the EOI form. * Land adjoining Roads: Urban – 10000 sq. feet & Highway 12000 sq. feet and Investment 1 Cr+* * "Long Lease” of Land. * Will vary by location. Investment excludes land value * Application Fees. General 15300/- OBC 12300/- ST/SC 10700/- All Application Charges Refundable EXPRESSION OF INTEREST First Name Last Name Email Password Mobile No. State Select Andaman and Nicobar Islands Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Dadra and Nagar Haveli Daman and Diu Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Lakshadweep Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry (UT) Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttar Pradesh Uttarakhand West Bengal District Proposed Locality Adress/City Source of Information Select Digital Ad Newspaper Ad Contacted by Company Current Business Select Transportation & Logistics Petroleum Products & Dealership Real Estate & Housing Automobile related Construction Utilities Agriculture Others Retail Location Category Select Rural Urban Last Year Turn Over Plot Length (in Meters) Plot Breath (in Meters) Caste Category Select General OBC SC/ST Amount 0 Invalid Captcha Proceed -------------------------------------------------------------------------------- DISCLAIMER * Submission of the information by you does not guarantee any commitment by the company. * Company reserves the right to reject any application at its sole discretion without assigning any reason or intimation. * We do not have any agents to facilitate Channel Partner appointments, kindly do not deal with any third party who assure grant of dealership etc. to you. Home | About RBML | Privacy Policy | Terms and Condition | Refund Policy | Pricing | Contact us | Applicant Login | Admin Login