State Bank Collect

SB Collect

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NAME *

MOBILE NUMBER *

NAME OF STATE/CITY *

MLA CONSTITUENCY *

ID TYPE OF DONOR *

ID NUMBER *

AMOUNT *

Remarks :

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Individual

Organisation / Corporate

Name * :

Date of Birth * :

Mobile No * :

On successful completion of payment,you will receive the transaction reference number on this mobile number

Email ID :

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Your Name * :

Organisation Name * :

Date of Incorporation * :

Mobile No * :

On successful completion of payment,you will receive the transaction reference number on this mobile number

Email Id :

On successful completion of payment, you will receive the transaction reference number on this email ID

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