Application Form OFD

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APPLICATION

DATA EXECUTIONS OPERATOR


Agreement signed for

Offline Data Entry

Date of signing the agreement


: .

Number of assignments signed-up in agreement


: .

DEOs Full Name


: .

Company Name
: .

Service Tax Number (if any)


: .

Full Correspondence Address


: .

: .

Email Address
: .
Mobile: ..
Sales Persons Name
: .
City: ..
Email Address
: .
Mobile: ..
Total Consultancy Paid (Rs)
: .....
Date: .....

Payment

Bank account details where DEO wants to deposit/transfer the paychecks and
refunds:
Bank Name
: .

Account Holders Name


:
.

Account Number
: .

Branch Name
:
IFSC Code: ..
___________________
Signature (Second Part)
Authorized Signatory
(Name of end-client in this parentheses)

PAN Number

Acknowledgement
I have understood all the terms and clauses for offered job work and their penalty
clauses as well. I am acknowledging that the above information is correct and must be
using for all kind of future payments, refund and other claims for disputes (if any) as well.
Send this acknowledgement form at below email:
submit@shivam-infotech.com
This acknowledgement form must submit back to us within 7 calendar days from date of
issuing first assignment. Otherwise first party is at liberty to terminate the work without
any notice.

___________________
Signature (Second Part)
Authorized Signatory
(Name of end-client in this parentheses)

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