Membership Application Form | Apply Online

Applicant Details Personal information of the applicant

Full Name

Father's / Husband's / Wife's Name

Date of Birth

Age

Gender

Male

Female

Other

Marital Status

Married

Unmarried

Occupation

Annual Income (₹)

Contact Details How we can reach you

Mobile Number

WhatsApp Number

Email Address

Address Details Current and permanent address

Residential Address (Current)

City

State

PIN Code

Permanent Address

City

State

PIN Code

Employment / Business Details Your professional information

Company / Business Name

Designation

Office Address

Office Contact

Years in Employment / Business

Identification Details Government-issued IDs

Aadhaar Number

PAN Number

Voter ID

Driving Licence

Passport No. (Optional)

Bank Details Your banking information for transactions

Bank Name

Branch

Account Holder Name

Account Number

IFSC Code

UPI ID (Optional)

Nominee Details Person to be nominated

Nominee Name

Relationship

Date of Birth

Mobile Number

Emergency Contact In case of emergency

Contact Name

Relationship

Mobile Number

Documents Submitted Please tick documents you are submitting

Aadhaar Card

PAN Card

Passport Size Photos

Address Proof

Income Proof

Bank Passbook

Cheque Leaf

Declaration Please read and accept before submitting

I hereby declare that all information furnished in this application is true and correct to the best of my knowledge. I agree to abide by all the rules, policies, terms, and future amendments of Scallops Fincorp. I understand that any false information may result in cancellation of my membership and other actions as deemed appropriate by the company.