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01

Basic Infomation

NPWF Membership Form

1. Basic Infomation

Note : * indicates 'Compulsory Fields'

First Name *
Last Name
Email ID
Phone Number *
Birth Date
AGE
Gender * Male Female Transgender

Father Name
Mother Tongue
Address
State *
Pincode
Upload your Photo Upload your Passport size Photo
Aadhar Card Number:

02

Family Details

2. Family Details (Optional)

Please Fill Your Family Details.

Name :

Relation :

DOB :

Education :

03

Occupation Details

3. Ocupation Details

Note: Fill all * Required Fields otherwise you Can't Submit the Form.

Occupation Type Business Job

Annual Income (INR)
Filing Tax Return? Yes No
Having LIC Cover? Yes No
Having Mediclaim Cover? Yes No
Home Status? Owned Rented

Having Vehicle? Yes No


04

Mobile Verification

Mobile Verification & Password Creation (Final Step)

                               
Mobile Number Verification

Complete Mobile Verification to Enable Submit Button