Indian Railway Catering & Tourism Co - Operation Limited: (Registration Form)
Indian Railway Catering & Tourism Co - Operation Limited: (Registration Form)
Indian Railway Catering & Tourism Co - Operation Limited: (Registration Form)
(REGISTRATION FORM)
To be lled by Multilink Distributors requesting for Online Booking through
www.irctc.co.in
[To be submitted in Hard Copy & Soft Copy]
* MANDATORY
Company Name*
Person Representing Company
First Name*
Middle Name *
Last Name *
Date of Birth*
Ofce Address *
City *
State*
Pincode*
Country *
India
Phone Number *
Fax Number *
Email Id *
Contract Begin Date*
Contract End Date*
Demand Draft No.*
Date of issue *
Drawn on the Bank *
Multilink Distributors User Name As
in his Digital Certicate
Certication Authority Name*
Digital Certicate Serial Number *
Name* _______________________
Date* _______________________
Digital Signature
Registration Form for Digital Signature Certicate [Idividuals]
Customer Identication Number: ________________
Instructions:
Afx recent
passport size
photograph of
the Applicant
2 Yrs.
4. RESIDENTIAL ADDRESS
Town/City/District
State/Union Territory
Pin
Telephone No.
(STD COde)
Fax No
Mobile Phone No.
5. DATE OF BIRTH
(eg.20
0)
6. E-MAIL ADDRESS
7. IDENTITY DETAILS
(Please tick and
Licensed Certifying Authority
Applicant Signature
Executive Name
Distributor Name
Refered by
Branch Name
Director Signature