05/04/2022, 12:10 CSC e-Gov
CSC VLE REGISTRATION
APPLICATION REFERENCE NUMBER : 5992397931240697
PERSONAL DETAILS
Name : Jadeja Devendrasinh
Gender : Male
D.O.B : 1989-05-14
Email : rishijadeja@[Link]
Mobile : 9825695293
KIOSK DETAILS
KIOSK Name : ONLINE SEVA KENDRA
BANKING DETAILS
IFSC CODE : ICIC0000051
ACCOUNT TYPE : Saving
ACCOUNT NUMBER : 005101537723
BANK : Icici Bank Limited,
ACCOUNT HOLDER : Devendrasinh Jadeja
PAN TYPE : Individual
PERSONAL PAN NUMBER : AQDPJ0470A
NOTE: It is mandatory for the user to print/download a copy of the form and submit the same to the District Manager
available in the nearest CSC office along with a copy of self attested documents (cancelled cheque/passbook, PAN
card, applicant image).
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