DSA Loan Agent Registration

 Personal Information

Basic applicant details and contact information

 Constitution & Date Details

Business structure and relevant dates

 Address Details

Communication, residence, and business address information

Communication Address*
Residence Address
Business Address

 Authorized Signatory Details

Person authorized to sign on behalf of the applicant

Upload PDF file only (Max 5MB)

 Professional Details

Experience, products, and operating locations

Enter amount in words like "5 lakhs", "2 crores", or "50 thousand"
Search and select multiple cities where you operate

 Financial Information

PAN, GST, and tax-related details

Format: ABCDE1234F (5 letters + 4 digits + 1 letter)
Format: 22ABCDE1234F1Z5 (15 characters)

 Bank Details

Account information for payment processing

Format: PNBN0001234 (Bank code + 0 + branch code)

 DSA History

Previous experience as DSA with other institutions

 References & Additional Information

Professional references and achievements

Leave empty if not applicable
Leave empty if not applicable

 Declaration

Terms and conditions acceptance

I declare that the information I have provided is accurate and complete to the best of my knowledge. I hereby authorize PNBCSL and its affiliates to call, email, send a text through the Short Messaging Service (SMS) and/or WhatsApp for the purpose of processing my DSA application and providing updates on the same.