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MEMBERSHIP INFORMATION

Inclusive Care Platform for Gig Community – GigSURE

GigSURE : An affinity Membership Program of eRenovision Management (I) Pvt. Ltd powered by Gram-Haat Initiative. This Annual membership is property of eRMPL issued to its GigSURE Members only. This Membership is governed by GigSURE and it's Associate Partner's Terms & Conditions may be amended from time-to-time with prior notice.

This is Non-Transferable in benefit of registered member based on self- declared information by Proposer intent to be the Member. All applicable benefits are as per eligibility criteria in line with rule & policy of governing body / government entity and / or Service provider. Member's information remains strictly confidential as per privacy policy with consent of Proposer as per submitted application herewith.

GigSURE initiative of eRenovision Management(I) Pvt.Ltd as Startup (CERTIFICATE NO: DIPP104951) by DIPP - Government of India

Proposer Information

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Facilitator Information

Facilitator *

Facilitator Name *

Facilitator Code *

Proposer Information

Full Name *

Date of Birth *

Gender *

Marital Status *

Occupation *

Net Monthly Income *

Height (Inch) *

Weight (Kg) *

Blood Group *

Pre Disease (If any)

Primary Health *

Total Family Members *

MA Yojana Number

Proposer Contact Details

Address *

City / Town / Village *

Taluka *

District *

State *

Country *

Pin Code *

Email *

Contact Number *

WhatsApp Number *

Proposer Bank Details (Aadhaar linked only)

Bank Name *

Branch Name *

Account Number *

IFSC Code *

UPI ID

Proposer Nominee Declaration

Nominee Name as per Aadhaar Card *

Nominee Date of Birth *

Nominee Relation *

Nominee Contact Number *

Other Information

Self Registered Vehicle *

Vehicle Type *

RTO Number *

Own Property *

Insurance (If any) *

Upload Required Documents

Please upload clear and valid documents. Supported formats: JPG, PNG, PDF (Max size: 5MB each).

Aadhaar Card Front Image *

Aadhaar Front

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or drag and drop

Aadhaar Card Back Image *

Aadhaar Back

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PAN Card Image *

PAN Card

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Bank Details Proof Image *

Bank Proof

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Nominee Aadhaar Front Image *

Nominee Front

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Nominee Aadhaar Back Image

Nominee Back

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Signature Image *

Signature

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Review Your Application

Please review the information below before proceeding to payment. You can go back to make changes.

Proposer Information

Facilitator Direct

Facilitator Name —

Facilitator Code —

Full Name —

Date of Birth —

Gender —

Marital Status —

Occupation —

Net Monthly Income —

Height (Inches) —

Weight (Kg) —

Blood Group —

Pre-existing Disease —

Primary Health —

Family Members —

MA Yojana Number —

Contact Details

Address —

City / Town / Village —

Taluka —

District —

State —

Country —

PIN Code —

Email —

Contact Number —

WhatsApp Number —

Bank Details

Bank Name —

Branch Name —

Account Number —

IFSC Code —

UPI ID —

Nominee Declaration

Nominee Name —

Nominee Date of Birth —

Relationship —

Nominee Contact —

Other Information

Self-Registered Vehicle No

Vehicle Type —

RTO Number —

Own Property —

Insurance —

Uploaded Documents

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I have reviewed the information above and confirm that it is accurate to the best of my knowledge.

Scan & Pay

Scan the QR code using any UPI app to make the payment of ₹1,178.82/-.

UPI ID

View Bank Details

Account Number 989088

IFSC Code 8789

Bank Name bob

Branch Name vadodara

Payment Instructions

Scan the QR code using any UPI app.
Pay the exact amount of ₹1,178.82/-.
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₹1,178.82 Sample Receipt GigSURE UPI Transaction ID XXXXXXXXXXXX

Payment Details

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Transaction Number / UTR *

Paid Amount (₹) *

Mode of Payment *

Annual Membership Fee ₹999.00

GST / Applicable Taxes (18.00%) ₹179.82

Total Payable ₹1,178.82

Become a GigSURE Member

Inclusive Care Platform for Gig Community – GigSURE

Facilitator Information

Proposer Information

Proposer Contact Details

Proposer Bank Details (Aadhaar linked only)

Proposer Nominee Declaration

Other Information

Upload Required Documents

Review Your Application

Proposer Information

Contact Details

Bank Details

Nominee Declaration

Other Information

Uploaded Documents

Scan & Pay

Payment Instructions

Upload Transaction Receipt *

Payment Details

Registration Submitted Successfully!

Thank you for joining GigSURE.

Membership
Certificate

Digital
Member Card

Payment
Receipt

Become a GigSURE Member

Inclusive Care Platform for Gig Community – GigSURE

Facilitator Information

Proposer Information

Proposer Contact Details

Proposer Bank Details (Aadhaar linked only)

Proposer Nominee Declaration

Other Information

Upload Required Documents

Review Your Application

Proposer Information

Contact Details

Bank Details

Nominee Declaration

Other Information

Uploaded Documents

Scan & Pay

Payment Instructions

Upload Transaction Receipt *

Payment Details

Registration Submitted Successfully!

Thank you for joining GigSURE.

MembershipCertificate

DigitalMember Card

PaymentReceipt

Membership
Certificate

Digital
Member Card

Payment
Receipt