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Reg Price: Tk. 6,000.00 + Vat: Tk. 900.00 = Total: Tk. 6,900.00

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Date of Birth *

Password*

Confirm Password*

Virtual Sweets Store (Authorized Dealer) Name *

Marital Status *

Same as Present Address

Division *

District *

Upazilla *

Union *

Ward *

House Number *

Road *

Village *

Second Contact Number

TIN Number

Emergency Contact Number

I declare that all the information given in this form is correct and true.