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Referral Payout Form
Personal Details
Please fill your Name
*
Please fill your Email Id
*
Please fill your Phone Number
*
Name of the Person You Referred
*
Email Address of the Referred Person
*
Why did you refer this person?
*
Bank Account Details
Account Holder Name
*
Bank Name
*
Account Number
*
IFSC Code
*
Please add Pan Card ( upload on drive - attach the link below)
*
Click to choose a file or drag here
Consent & Declaration
Referral Verification Consent
(Required)
*
I confirm that the referral information provided by me is accurate and genuine.
I authorize the organization to conduct verification checks regarding the referral journey, including validating the referral source, communication history, and eligibility criteria.
I understand that referral rewards will be processed only after successful verification of the referral.
Important Declaration
Acknowledgement
*
I understand that if any discrepancy, misrepresentation, fraudulent activity, duplicate referral claim, or incorrect information is identified during the verification process, my referral reward payment may be placed on hold, delayed, or rejected at the sole discretion of the organization.
I certify that all information submitted in this form is true and accurate to the best of my knowledge.
Submit
