Customer Name* Customer Mail ID* Customer Contact No. for Backend to Call* Customer Contact No. Alternate Contact No. Business Name* Address Line 1* Address Line 2* Address Line 3 Current Location* City* State* Pin Code* Page Status New Page Existing Google Page Link* Google 360 VT Basic Premium Google 360 VT(SFT) 0-500 500-1000 1000-1500 1500-2000 2000-2500 2500-3000 3000-3500 3500-4000 4000-4500 4500-5000 Other If other Comment* Photography Instructions Total Package Amount Taxation Yes No Invoice Name GST No. PAN No. Invoice Address Mode of Payment Cheque Online Cheque Name Cheque No. Bank Name Cheque Date On Date PDC NA Online Transaction ID Registration Date Upload Selfie* Cheque Leaf or Online Transaction Screenshot* Area Name* BA Name* BA Email* BA Code* BA Pan No.* Comments