Registration Panel Window 📝Application formTitle: The location selection for LPG dealership, Type of RO: regular , Mode of selection: Draw of lots Retail Outlet Eligibility Criteria for Land 15 X 15 Sq.M. (Mininum Size)Apply As *IndividualPartnershipName of Company *Indane Gas (IOCL)HP Gas (HPCL)Bharat Gas (BPCL)👤Personal InformationFrist Name *Last NameGenderMaleFemaleMobile Number *Res. Address *Pincode *State *District *Email Address *PAN Number *Whether Applicant is Indian Citizen *YesNoPhysical Disability *YasNoDate of Birth *Father/Husband Name *Marital Status *(In case of married women Husband's Name)SingleMarriedWidowerDivorce🎓Applicant's Education Qualification (Minimum 10th pass or Equivalent)Qualification *Board/University/Institute *Year *Name(s) of the owner of Land/Leaseholder *Relationship with Application *Khasra No / Khatouni / Gut No / Survey No *Location of the Land *Dimension of LandFrontage in Meter *Depth in Meter *Area (Sq.M) *are you efilling to transfer the land on sale / long lease of the LPG Gas DealershipYesNo✅DeclarationConsent *I, .................... .................... of/son of/wife of Shri .................... .................... .................... hereby confirm that I have been authorized to submit this application on behalf of M/s .................... and the information given above is true and correct. Any wrong information/misrepresentation/suppression of facts will make us ineligible for this Dealership. That if any information/declaration given by us in application or in any document submitted by us in support of application for award of the dealership shall be found to be untrue or incorrect or false, the Company would be within its rights to withdraw/terminate letter of intent of the dealership (if already appointed) and that we would have no claim, whatsoever, against the Corporation for such withdrawal/termination. Yes, I agree with the privacy policy and terms and conditions. Accept .🪪 Applicant PhotoApplicant Photo *Choose FileNo file chosenDelete uploaded fileApplicant Address Proof *Choose FileNo file chosenDelete uploaded filePAN Card *Choose FileNo file chosenDelete uploaded fileSubmit