PaymentForm

06/01/16, 1:30 PM

(ITP Web Registration Acknowledgment Form)

Date:______________
TIN NO:

ACK NO. 119177455H

Name of
:Mrs Arshi Khursheed
Applicant
Date of
:15-Jul-1982
Birth
:Payment by Online ( 344)
Mode of
Payment (Successful online payment received against transaction reference
number (Trace number): 33886 33886 for your NSR web-registration)
Employer
:HCL Technologies Ltd
Name
Employee
:51503137
Number

Valid Up
To Date

:25/02/2016

Please affix your latest

Photograph

Signature
(Please sign in the centre of the box)

Note :
* To complete your registration please visit any Point of Service (POS) office. If you do not complete your registration
within 50 days of issuance of Acknowledgement Number, your data will be purged from the system.
* You need to take print-out of this form to the POS along-with ORIGINAL proof of Photo Identity [Voter's Id
card/Passport/Driving License/Bank Pass Book (with Photo)/College ID card (not more than 4 years old)/PAN
card/Employment Identity Card].
* I have read, understood and I agree to the terms and conditions available on NSR website
https:\\nationalskillsregistry.com relating to my joining and using NSR and I agree to the same.
ACKNOWLEDGEMENT SLIP(For the use of POS only)
TIN NO :
Ack No : 119177455H
Name of Applicant : Mrs Arshi Khursheed
POS ID :
1. Received the Application form for Registration as ITP in the National Skills Registry and payment made by
ITP for Registration is Payment through Online.
Date:___________
(POS Seal and Signature)
Print

https://nationalskillsregistry.com/nasscom/pg/OnlinePayment

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