LAKSHYA LEVEL MARKETING PVT. LTD.,
173 IInd Floor,
Raghuleela Mega Mall,
Behind Poisor Bus Depot,
Kandivali(W),Mumbai-92
Tel.: 4247 7000,4247 7070(Board Lines)
Email : Info@lakshyaindia.in
Website : www.lakshyaindia.in
 
   SPONSOR INFORMATION
  Sponsor ID*   Sponser Name
 
  PIN Serial No.*   PIN No.*
  Placement*  LEFT  RIGHT
   PERSONAL INFORMATION
  Name *
  Maiden Name
  Mothers Maiden*
  Address*
  Date of Birth * Age :
  Gender *   Occupation
  District   City/Town *
  State *   PIN Code *
 Country*  
  Phone No (Res.)   Mobile*
  Phone No (Off.)   Email ID*
  BANK INFORMATION
  Payee Name
  Bank Name   Account No
  Branch Code   Branch Name
  PAN No   IFSC Code
  DEMAT INFORMATION
  DP Name
  DP ID   Demat Acc. No.
  PRODUCT INFORMATION
  Product Name  
  Select Category
  NOMINEE INFORMATION
  Nominee Name *   Relation
  LOGIN INFORMATION
 Secret Question *  Answer *
  DOCUMENTS/PAYMENTS DELIEVERY
  From Office By Courier By Post *