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FORM FOR REMITTANCE

Name*
Address 1*
Address 2*
Address 3*
Pin*
City
State
Phone
Email*

PURPOSE OF PAYMENT
	Digital Signature Certificate
	No of Digital Signature Certificate
	One Year Package	Rs /-
	Two Year Package	Rs /-
	Renewal	Rs /-
	DSC Total Amount	Rs /-
	Online Incorporation	Rs /-
	e-Search	Rs /-
	Any other service Please specify	Rs /-
	(Like, Invoice No, Order No , Service name)

Grand Total Amount		Rs /-

Instructions/Comments (if any)


DECLARATION
I hereby declare that the information provided by me is true and correct to the best of my knowledge. I have read and understood all the rules and regulations and agree to abide by the same. I authorize Corporate Professionals.Com Pvt Ltd, New Delhi to charge the credit card towards the purpose indicated above. I understand that the jurisdiction for all disputes(if any) relating to the aforesaid purposes is New Delhi India.
I Agree