iMart - Wholesale :: Seller Registration

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Seller Info

First Name *

Please fill first name.

Last Name *

Please fill last name.

Email *

Please fill email.

Mobile *

Please fill mobile number.

Name of Business *

Please fill name of business.

PAN *

Please fill PAN number.

Upload Your PAN ID *

Please upload PAN ID.

Document should be jpg/jpeg format.

SSN *

Please fill SSN.

Upload SSN *

Please upload SSN document.

Document should be jpg/jpeg format.

EIN *

Please fill EIN.

Upload EIN *

Please upload EIN document.

Document should be jpg/jpeg format.

State Tax ID *

Please fill state tax id.

Upload State Tax Id *

Please upload state tax document.

Document should be jpg/jpeg format.

Government ID *

Please fill government id.

Upload Government ID *

Please upload government id document.

Document should be jpg/jpeg format.

State Tax Expiry (if applicable)

Government ID Expiry (if applicable)

Registered Business Address

Business Location *

Plase select country.

Address 1 *

Please fill address 1.

Address 2 *

Please fill address 2.

State *

Please select state.

City

Please select city.

Zip *

Please fill zip code.

Primary / Home Address

Address 1 *

Please fill address 1.

Address 2 *

Please fill address 12.

Country *

Please select country.

State *

Please select state.

City

Please select city.

Zip *

Please enter zip code.

Password Info

Password *

Please enter password.

Password should minimum 8 characters.

Confirm Password *

Please enter confirm password.

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