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News Paper Name(Required)

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Paper Language(Required)

RNI Number(Required)

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Owner / Editor Name(Required)

First Name Last name / Surname

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Phone

Address(Required)

Full Address City Name State / Province / Region Pin Code Number

From Date(Required)

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To Date(Required)

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Username(Required)

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Password(Required)

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Mobile(Required)

DECLARATION BY THE APPLICANT(Required)

I agree to the Terms and Condition.

I hereby declare that the information given in this application is true and correct to the best of my knowledge and belief. In case any information given in this application proves to be false or incorrect, I shall be responsible for the consequences.

I also declare that if any information provided by me is found false, my application may be rejected at any point of time.