Please Submit Your Grievance
Fields marked with * are mandatory
 * Request Category :
Salutation
 * BC/BF Code:
 * Name of business correspondent/Business Facilitator
 * Mobile Number of BC/BF
 * Email-Id of BC/BF :
 * complete Address of BC/BF
 * Settlement Account Number of BC/BF :
 * Saving Account Number of BC/BF :
 * Branch Name and Number to which BC/BF is linked :
 * Name of TSP under which BC/BF is Working :
 * Nature of Complaint :

 * Complaint in Brief
(500 characters only)
  List of Documents atteched with complaint
  Upload Document File


[Only two files are allow]
 *Date when approached to Branch Manager/TSP
 * Enter the code as shown below
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