Items marked with an * are required.
Retailer Name*
Retailer CNIC*:
Outlet Name*:
Outlet Address*:
Retailer Mobile # 01*:
Retailer Landline #:
Retailer Mobile # 02
City*:..::: SELECT :::..ABBOTTABADABDUL HAQEEMAHMAD PUR SIALAHMED PUR EAST - AAHMED PUR EAST - BALI PURARIFWALAATTOCKAWARANBADINBAGHBAHAWALPURBAHAWLNAGARBANNUBATKHELABATTAGRAMBHAIPHERUBHAKARBHALWALBHERABHIMBERBUNAIRBUREWALACHAK JHUMRACHAKWALCHAMANCHARSADDACHICHAWATNICHINIOTCHISHTIANCHITRALCHOWK AZAMCHUNIAND.I.KHANDADUDADYALDALBANDINDARYAKHANDASKADEEPALPURDERA MURAD JAMALIDG KHANDHARANWALADIGRIDINADINGADIRESSA KHAILFAISALABADFATEHJANGFATEHPURFAZILPURFORTABBASGILGITGOJRAUJARKHANGUJRANWALAGUJRATHAFIZABADHAJEERAHALAHANGUHARIPURHAROONABADHASANABDALHASILPURHAVELIANHYDERABADISLAMABADJAHANGIRAJAHANIANJALALPUR PEERWALAJAMPURJARANWALAJAUHAR ABADJHANGJHELUMKAHROR PAKAKALABAGHKALAR SYEDIANKALATKALLUR KOTKAMALIAKAMONKIKAMRAKARACHI AKARACHI BKARAKKAROR LAL EASONKASURKATLANGKHAIGALAKHAN BELAKHANPURKHARANKHARIANKHENEWALKHIPROKHUSHABKHUZDARKOHATKOT ADDUKOT CHUTTAKOT METHONKOTLIKUCHLAKKUNJAHKUNRILACHILAHORELALA MUSALAYYAHLIAQAT PUR/ALLAH ABADLODHRANLORALAIMAILSIMAMO KANJUNMANDI BHAU DINMANGORAMANSEHRAMARDANMATLIMEHRABPURMIANCHANNUMIANWALIMINCHANABADMIRPURMIRPURKHASMITHIMOROMULTAN - AMULTAN - BMURIDKYMUZAFFARABADMUZAFFARGARHNALLNANKANANARANGNAROWALNAWABSHAHNOSHERANOUSHKINOWSHERAOKARAOKARA CANTTP D KHANPABBIPAKPATTANPALANDRIPANJGOORPASROORPATTOKIPD KHANPESHAWAR APESHAWAR BPHALIAPIR MAHALPISHINQAID ABADQILLA SAIF ULLAHQUETTARAHIM YAR KHANRAIWINDRAJANPURRAWALAKOTRAWALPINDISADIQABADSAHIWALSAHIWAL FAROOQASAKHI SARWARSAMBRIALSANGHARSANGLA HILLSARAYNOURANGSARGODHASHABQADARSHADADPURSHAH PURSHAHKARGHARSHAHKOTSHEIKHPURASHINKIYARISIALKOTSIBBISILLANWALISKARDUSOHAWASUKKURSUMMANDRISURABSWABIT T SINGTAKHTBAITALAGANGTANDLIANWALATANDO ADAMTANDO ALLAHYARTANDO M.KHANTANKTAXILATHALLTHATTATIMERGRAHTOPITRARKHELTURBATUGIUMARKOTVEHARIWAH CANTTWAZIRABADYAZMANZHOB
Business Type*:..::: SELECT :::..General StoreMobile ShopBakeryPharmacyVideo / Internet ShopHardware StorePan ShopOther
Currently engaged in selling Mobile operators product of other operators:..: SELECT :..YesNo
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