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Portal User Activation

Please enter information requested on the form.
Click on Activate button when done.
Fields marked * indicate compulsory field.

Account Number* : eg: D926739341104
Company Registration Number* : eg: PS/234567-U
Fixed-Line Number* : eg: 0392354123
Your Name :
Mobile Number :
Designation :
Email Address :
Prefered Login ID* :
Password* :
Retype Password* :
Secret Question* :
Answer To Secret Question* :