{"id":87,"date":"2026-08-01T16:56:49","date_gmt":"2026-08-01T16:56:49","guid":{"rendered":"https:\/\/gpswebregistrar.com\/?page_id=87"},"modified":"2026-08-01T17:23:59","modified_gmt":"2026-08-01T17:23:59","slug":"passbook-application","status":"publish","type":"page","link":"https:\/\/gpswebregistrar.com\/?page_id=87","title":{"rendered":"Passbook Application"},"content":{"rendered":"<div id=\"pba-app\" class=\"pba-wrap\">\n\n\t<div id=\"pba-alert\" class=\"pba-alert\" style=\"display:none;\"><\/div>\n\n\t<form id=\"pba-form\" novalidate>\n\n\t\t<!-- STEP 0: Application Type -->\n\t\t<section class=\"pba-card\">\n\t\t\t<h2>Passbook Application<\/h2>\n\t\t\t<label class=\"pba-label\">Application Type <span class=\"req\">*<\/span><\/label>\n\t\t\t<div class=\"pba-radio-row\">\n\t\t\t\t<label><input type=\"radio\" name=\"application_type\" value=\"New\" checked> New<\/label>\n\t\t\t\t<label><input type=\"radio\" name=\"application_type\" value=\"Duplicate\"> Duplicate<\/label>\n\t\t\t\t<label><input type=\"radio\" name=\"application_type\" value=\"Lost\/Damaged\/Filled\/Torn\"> Lost \/ Damaged \/ Filled \/ Torn<\/label>\n\t\t\t\t<label><input type=\"radio\" name=\"application_type\" value=\"Update\"> Update<\/label>\n\t\t\t<\/div>\n\t\t<\/section>\n\n\t\t<!-- CIF lookup (Duplicate \/ Lost.. \/ Update) -->\n\t\t<section class=\"pba-card pba-section\" data-types=\"Duplicate,Lost\/Damaged\/Filled\/Torn,Update\">\n\t\t\t<h3>Existing Customer Lookup<\/h3>\n\t\t\t<div class=\"pba-row\">\n\t\t\t\t<div class=\"pba-field\">\n\t\t\t\t\t<label>Customer ID (CIF) <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<input type=\"text\" name=\"cif_number\" id=\"cif_number\" inputmode=\"numeric\">\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"pba-field pba-field-btn\">\n\t\t\t\t\t<button type=\"button\" id=\"pba-cif-lookup\" class=\"pba-btn pba-btn-secondary\">Fetch Details<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<p class=\"pba-hint\" id=\"cif-status\"><\/p>\n\t\t<\/section>\n\n\t\t<!-- Field of Update (Update only) -->\n\t\t<section class=\"pba-card pba-section\" data-types=\"Update\">\n\t\t\t<h3>Field to Update<\/h3>\n\t\t\t<label class=\"pba-label\">Select Field <span class=\"req\">*<\/span><\/label>\n\t\t\t<select name=\"field_of_update\" id=\"field_of_update\">\n\t\t\t\t<option value=\"\">-- Select --<\/option>\n\t\t\t\t<option value=\"Mobile No.\">Mobile No.<\/option>\n\t\t\t\t<option value=\"Address\">Address<\/option>\n\t\t\t\t<option value=\"Branch Name\">Branch Name<\/option>\n\t\t\t\t<option value=\"Email ID\">Email ID<\/option>\n\t\t\t\t<option value=\"Account Type\">Account Type<\/option>\n\t\t\t\t<option value=\"Nominee Details\">Nominee Details<\/option>\n\t\t\t<\/select>\n\t\t\t<p class=\"pba-hint\">Only the selected field's section below becomes editable.<\/p>\n\t\t<\/section>\n\n\t\t<!-- APPLICANT DETAILS (New) -->\n\t\t<section class=\"pba-card pba-section\" data-types=\"New\">\n\t\t\t<h3>Applicant Details<\/h3>\n\t\t\t<div class=\"pba-grid\">\n\t\t\t\t<div class=\"pba-field\"><label>Applicant Name <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<input type=\"text\" name=\"applicant_name\" pattern=\"[A-Za-z\\s.]+\" required><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Date of Birth <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<input type=\"date\" name=\"dob\" id=\"dob\" required><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Gender <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<select name=\"gender\" required><option value=\"\">--Select--<\/option><option>Male<\/option><option>Female<\/option><option>Other<\/option><\/select><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Mobile Number <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<input type=\"tel\" name=\"mobile_number\" pattern=\"[6-9]\\d{9}\" maxlength=\"10\" required><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Email ID<\/label>\n\t\t\t\t\t<input type=\"email\" name=\"email\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Aadhaar Number <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<input type=\"text\" name=\"aadhaar\" maxlength=\"12\" pattern=\"\\d{12}\" required><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>PAN Number<\/label>\n\t\t\t\t\t<input type=\"text\" name=\"pan\" maxlength=\"10\" pattern=\"[A-Z]{5}[0-9]{4}[A-Z]{1}\" style=\"text-transform:uppercase;\"><\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\n\t\t<!-- APPLICANT DETAILS read-only (Duplicate\/Lost\/Update, autofilled via CIF) -->\n\t\t<section class=\"pba-card pba-section\" data-types=\"Duplicate,Lost\/Damaged\/Filled\/Torn,Update\">\n\t\t\t<h3>Applicant Details (Auto-fetched)<\/h3>\n\t\t\t<div class=\"pba-grid\">\n\t\t\t\t<div class=\"pba-field\"><label>Applicant Name<\/label><input type=\"text\" name=\"applicant_name_af\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Date of Birth<\/label><input type=\"text\" name=\"dob_af\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Gender<\/label><input type=\"text\" name=\"gender_af\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Mobile Number<\/label><input type=\"text\" name=\"mobile_number_af\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Email ID<\/label><input type=\"text\" name=\"email_af\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Aadhaar Number<\/label><input type=\"text\" name=\"aadhaar_af\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>PAN Number<\/label><input type=\"text\" name=\"pan_af\" readonly><\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\n\t\t<!-- ADDRESS -->\n\t\t<section class=\"pba-card pba-section\" data-types=\"New,Duplicate,Lost\/Damaged\/Filled\/Torn,Update\">\n\t\t\t<h3>Address Details<\/h3>\n\t\t\t<div class=\"pba-grid\">\n\t\t\t\t<div class=\"pba-field\"><label>PIN Code <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<input type=\"text\" name=\"pincode\" id=\"pincode\" maxlength=\"6\" pattern=\"\\d{6}\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Door No <span class=\"req\">*<\/span><\/label><input type=\"text\" name=\"door_no\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Street <span class=\"req\">*<\/span><\/label><input type=\"text\" name=\"street\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Colony\/Locality <span class=\"req\">*<\/span><\/label><input type=\"text\" name=\"colony\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Village\/City<\/label><input type=\"text\" name=\"village_city\" id=\"village_city\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Mandal<\/label><input type=\"text\" name=\"mandal\" id=\"mandal\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>District<\/label><input type=\"text\" name=\"district\" id=\"district\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>State<\/label><input type=\"text\" name=\"state\" id=\"state\" readonly><\/div>\n\t\t\t<\/div>\n\t\t\t<p class=\"pba-hint\" id=\"pincode-status\"><\/p>\n\t\t<\/section>\n\n\t\t<!-- BANK DETAILS (New) -->\n\t\t<section class=\"pba-card pba-section\" data-types=\"New\">\n\t\t\t<h3>Bank Details<\/h3>\n\t\t\t<div class=\"pba-grid\">\n\t\t\t\t<div class=\"pba-field\"><label>Bank Name<\/label><input type=\"text\" name=\"bank_name\" value=\"ICICI\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Branch Name <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<select name=\"branch_name\" id=\"branch_name\"><option value=\"\">--Select--<\/option><option>Uppal Kalan Branch<\/option><option>Ameerpet Branch<\/option><option>Secunderabad Branch<\/option><\/select><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Branch Code<\/label><input type=\"text\" name=\"branch_code\" id=\"branch_code\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>IFSC Code<\/label><input type=\"text\" name=\"ifsc\" id=\"ifsc\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Account Holder Name<\/label><input type=\"text\" name=\"account_holder_name\" id=\"account_holder_name\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Account Type <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<select name=\"account_type\"><option value=\"\">--Select--<\/option><option>Savings<\/option><option>Current<\/option><option>Salary<\/option><option>Joint<\/option><\/select><\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\n\t\t<!-- BANK DETAILS (Duplicate\/Lost) -->\n\t\t<section class=\"pba-card pba-section\" data-types=\"Duplicate,Lost\/Damaged\/Filled\/Torn\">\n\t\t\t<h3>Bank Details<\/h3>\n\t\t\t<div class=\"pba-grid\">\n\t\t\t\t<div class=\"pba-field\"><label>Account Number <span class=\"req\">*<\/span><\/label><input type=\"text\" name=\"account_number\" id=\"account_number\" pattern=\"\\d+\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Confirm Account Number <span class=\"req\">*<\/span><\/label><input type=\"text\" name=\"confirm_account_number\" pattern=\"\\d+\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Account Holder Name<\/label><input type=\"text\" name=\"account_holder_name_af\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Account Type<\/label><input type=\"text\" name=\"account_type_af\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Bank Name<\/label><input type=\"text\" name=\"bank_name_af\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Branch Name<\/label><input type=\"text\" name=\"branch_name_af\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Branch Code<\/label><input type=\"text\" name=\"branch_code_af\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>IFSC Code<\/label><input type=\"text\" name=\"ifsc_af\" readonly><\/div>\n\t\t\t<\/div>\n\t\t\t<p class=\"pba-hint\" id=\"account-match-status\"><\/p>\n\t\t<\/section>\n\n\t\t<!-- NOMINEE DETAILS -->\n\t\t<section class=\"pba-card pba-section\" data-types=\"New,Duplicate,Lost\/Damaged\/Filled\/Torn\">\n\t\t\t<h3>Nominee Details<\/h3>\n\t\t\t<div class=\"pba-grid\">\n\t\t\t\t<div class=\"pba-field\"><label>Nominee Required <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<select name=\"nominee_required\" id=\"nominee_required\"><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/div>\n\t\t\t\t<div class=\"pba-field pba-nominee-field\"><label>Nominee Name<\/label><input type=\"text\" name=\"nominee_name\"><\/div>\n\t\t\t\t<div class=\"pba-field pba-nominee-field\"><label>Nominee Date of Birth<\/label><input type=\"date\" name=\"nominee_dob\" id=\"nominee_dob\"><\/div>\n\t\t\t\t<div class=\"pba-field pba-nominee-field\"><label>Relationship<\/label>\n\t\t\t\t\t<select name=\"relationship\"><option value=\"\">--Select--<\/option><option>Spouse<\/option><option>Son<\/option><option>Daughter<\/option><option>Parent<\/option><option>Sibling<\/option><option>Other<\/option><\/select><\/div>\n\t\t\t\t<div class=\"pba-field pba-nominee-field\" id=\"guardian-field\" style=\"display:none;\">\n\t\t\t\t\t<label>Guardian Name <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<input type=\"text\" name=\"guardian_name\">\n\t\t\t\t\t<p class=\"pba-hint\">Required because the nominee is a minor (under 18 years).<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\n\t\t<!-- DOCUMENT UPLOADS (New) -->\n\t\t<section class=\"pba-card pba-section\" data-types=\"New\">\n\t\t\t<h3>Document Uploads <small>(.jpg \/ .pdf, max 1MB each)<\/small><\/h3>\n\t\t\t<div class=\"pba-grid\">\n\t\t\t\t<div class=\"pba-field\"><label>Aadhaar <span class=\"req\">*<\/span><\/label><input type=\"file\" name=\"doc_aadhaar\" accept=\".jpg,.jpeg,.pdf\" class=\"pba-file\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>PAN<\/label><input type=\"file\" name=\"doc_pan\" accept=\".jpg,.jpeg,.pdf\" class=\"pba-file\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Photograph <span class=\"req\">*<\/span><\/label><input type=\"file\" name=\"doc_photo\" accept=\".jpg,.jpeg\" class=\"pba-file\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Signature <span class=\"req\">*<\/span><\/label><input type=\"file\" name=\"doc_signature\" accept=\".jpg,.jpeg\" class=\"pba-file\"><\/div>\n\t\t\t<\/div>\n\t\t\t<p class=\"pba-hint pba-file-error\" id=\"file-error\"><\/p>\n\t\t<\/section>\n\n\t\t<!-- DOCUMENT UPLOADS (Duplicate\/Lost) -->\n\t\t<section class=\"pba-card pba-section\" data-types=\"Duplicate,Lost\/Damaged\/Filled\/Torn\">\n\t\t\t<h3>Document Uploads <small>(.jpg \/ .pdf, max 1MB each)<\/small><\/h3>\n\t\t\t<div class=\"pba-grid\">\n\t\t\t\t<div class=\"pba-field\"><label>Existing Passbook Copy <span class=\"req\">*<\/span><\/label><input type=\"file\" name=\"doc_existing_passbook\" accept=\".jpg,.jpeg,.pdf\" class=\"pba-file\"><\/div>\n\t\t\t\t<div class=\"pba-field pba-section\" data-types=\"Lost\/Damaged\/Filled\/Torn\"><label>FIR Copy <span class=\"req\">*<\/span><\/label><input type=\"file\" name=\"doc_fir\" accept=\".jpg,.jpeg,.pdf\" class=\"pba-file\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Self Declaration <span class=\"req\">*<\/span><\/label><input type=\"file\" name=\"doc_self_declaration\" accept=\".jpg,.jpeg,.pdf\" class=\"pba-file\"><\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\n\t\t<!-- EXISTING PASSBOOK DETAILS (Duplicate\/Lost) -->\n\t\t<section class=\"pba-card pba-section\" data-types=\"Duplicate,Lost\/Damaged\/Filled\/Torn\">\n\t\t\t<h3>Existing Passbook Details<\/h3>\n\t\t\t<div class=\"pba-grid\">\n\t\t\t\t<div class=\"pba-field\"><label>Existing Passbook Number <span class=\"req\">*<\/span><\/label><input type=\"text\" name=\"existing_passbook_number\" pattern=\"\\d+\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Reason <span class=\"req\">*<\/span><\/label><input type=\"text\" name=\"reason\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Date of Loss\/Damage<\/label><input type=\"date\" name=\"date_of_loss\"><\/div>\n\t\t\t\t<div class=\"pba-field pba-section\" data-types=\"Lost\/Damaged\/Filled\/Torn\"><label>Police Complaint Number <span class=\"req\">*<\/span><\/label><input type=\"text\" name=\"police_complaint_number\" pattern=\"[A-Za-z0-9]+\"><\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\n\t\t<!-- UPDATE: dynamic field containers -->\n\t\t<section class=\"pba-card pba-section\" data-types=\"Update\">\n\t\t\t<h3>Update Details<\/h3>\n\t\t\t<div id=\"update-field-mobile\" class=\"pba-update-field pba-grid\" style=\"display:none;\">\n\t\t\t\t<div class=\"pba-field\"><label>New Mobile Number <span class=\"req\">*<\/span><\/label><input type=\"tel\" name=\"new_mobile_number\" maxlength=\"10\" pattern=\"[6-9]\\d{9}\"><\/div>\n\t\t\t<\/div>\n\t\t\t<div id=\"update-field-email\" class=\"pba-update-field pba-grid\" style=\"display:none;\">\n\t\t\t\t<div class=\"pba-field\"><label>New Email ID <span class=\"req\">*<\/span><\/label><input type=\"email\" name=\"new_email\"><\/div>\n\t\t\t<\/div>\n\t\t\t<div id=\"update-field-address\" class=\"pba-update-field pba-grid\" style=\"display:none;\">\n\t\t\t\t<div class=\"pba-field\"><label>Door No<\/label><input type=\"text\" name=\"new_door_no\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Street<\/label><input type=\"text\" name=\"new_street\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Colony\/Locality<\/label><input type=\"text\" name=\"new_colony\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>PIN Code<\/label><input type=\"text\" name=\"new_pincode\" maxlength=\"6\" pattern=\"\\d{6}\"><\/div>\n\t\t\t<\/div>\n\t\t\t<div id=\"update-field-branch\" class=\"pba-update-field pba-grid\" style=\"display:none;\">\n\t\t\t\t<div class=\"pba-field\"><label>New Branch Name <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<select name=\"new_branch_name\"><option value=\"\">--Select--<\/option><option>Uppal Kalan Branch<\/option><option>Ameerpet Branch<\/option><option>Secunderabad Branch<\/option><\/select><\/div>\n\t\t\t<\/div>\n\t\t\t<div id=\"update-field-account-type\" class=\"pba-update-field pba-grid\" style=\"display:none;\">\n\t\t\t\t<div class=\"pba-field\"><label>New Account Type <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<select name=\"new_account_type\"><option value=\"\">--Select--<\/option><option>Savings<\/option><option>Current<\/option><option>Salary<\/option><option>Joint<\/option><\/select><\/div>\n\t\t\t<\/div>\n\t\t\t<div id=\"update-field-nominee\" class=\"pba-update-field pba-grid\" style=\"display:none;\">\n\t\t\t\t<div class=\"pba-field\"><label>Nominee Name <span class=\"req\">*<\/span><\/label><input type=\"text\" name=\"new_nominee_name\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Nominee Date of Birth<\/label><input type=\"date\" name=\"new_nominee_dob\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Relationship<\/label>\n\t\t\t\t\t<select name=\"new_relationship\"><option value=\"\">--Select--<\/option><option>Spouse<\/option><option>Son<\/option><option>Daughter<\/option><option>Parent<\/option><option>Sibling<\/option><option>Other<\/option><\/select><\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\n\t\t<!-- PAYMENT DETAILS -->\n\t\t<section class=\"pba-card\">\n\t\t\t<h3>Payment Details<\/h3>\n\t\t\t<div class=\"pba-grid\">\n\t\t\t\t<div class=\"pba-field\"><label>Fee Amount<\/label><input type=\"text\" name=\"fee_amount\" id=\"fee_amount\" value=\"0\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field pba-section\" data-types=\"Duplicate,Lost\/Damaged\/Filled\/Torn,Update\"><label>Payment Mode <span class=\"req\">*<\/span><\/label>\n\t\t\t\t\t<select name=\"payment_mode\" id=\"payment_mode\"><option value=\"\">--Select--<\/option><option>NEFT<\/option><option>PhonePe\/Google Pay<\/option><\/select><\/div>\n\t\t\t\t<div class=\"pba-field pba-section\" data-types=\"Duplicate,Lost\/Damaged\/Filled\/Torn,Update\"><label>Transaction ID <span class=\"req\">*<\/span><\/label><input type=\"text\" name=\"transaction_id\" id=\"transaction_id\"><\/div>\n\t\t\t\t<div class=\"pba-field pba-section\" data-types=\"Duplicate,Lost\/Damaged\/Filled\/Torn,Update\"><label>Payment Date <span class=\"req\">*<\/span><\/label><input type=\"date\" name=\"payment_date\" id=\"payment_date\"><\/div>\n\t\t\t\t<div class=\"pba-field pba-section\" data-types=\"New\"><input type=\"hidden\" name=\"payment_mode\" value=\"\"><em>Not applicable for New application.<\/em><\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\n\t\t<!-- DECLARATION -->\n\t\t<section class=\"pba-card\">\n\t\t\t<h3>Declaration<\/h3>\n\t\t\t<p>\n\t\t\t\t<label>\n\t\t\t\t\t<input type=\"checkbox\" id=\"declaration_accepted\" name=\"declaration_accepted\" value=\"Yes\">\n\t\t\t\t\tI have read and agree to the <a href=\"#\" id=\"pba-declaration-link\" target=\"_blank\" rel=\"noopener\">Bank Declaration<\/a>.\n\t\t\t\t<\/label>\n\t\t\t<\/p>\n\t\t\t<div class=\"pba-grid\">\n\t\t\t\t<div class=\"pba-field\"><label>Applicant Signature<\/label><input type=\"text\" id=\"signature_preview\" readonly placeholder=\"Auto-fetched from uploaded signature file\"><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Place<\/label><input type=\"text\" name=\"place\" id=\"place\" readonly><\/div>\n\t\t\t\t<div class=\"pba-field\"><label>Date<\/label><input type=\"text\" name=\"declaration_date\" id=\"declaration_date\" readonly><\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\n\t\t<div class=\"pba-actions\">\n\t\t\t<button type=\"submit\" id=\"pba-submit\" class=\"pba-btn pba-btn-primary\" disabled>Submit Application<\/button>\n\t\t<\/div>\n\t<\/form>\n\n\t<!-- Success modal -->\n\t<div id=\"pba-success-modal\" class=\"pba-modal\" style=\"display:none;\">\n\t\t<div class=\"pba-modal-content\">\n\t\t\t<h3>Application Submitted Successfully<\/h3>\n\t\t\t<p>Please save the following details for future reference:<\/p>\n\t\t\t<table class=\"pba-modal-table\">\n\t\t\t\t<tr><td>Application Number<\/td><td id=\"res-app-number\"><\/td><\/tr>\n\t\t\t\t<tr><td>Application Date<\/td><td id=\"res-app-date\"><\/td><\/tr>\n\t\t\t\t<tr><td>Application Type<\/td><td id=\"res-app-type\"><\/td><\/tr>\n\t\t\t<\/table>\n\t\t\t<button type=\"button\" class=\"pba-btn pba-btn-primary\" id=\"pba-modal-close\">Close<\/button>\n\t\t<\/div>\n\t<\/div>\n\n\t<!-- Declaration text modal -->\n\t<div id=\"pba-declaration-modal\" class=\"pba-modal\" style=\"display:none;\">\n\t\t<div class=\"pba-modal-content\">\n\t\t\t<h3>Bank Declaration<\/h3>\n\t\t\t<p class=\"pba-declaration-text\">\n\t\t\t\tI hereby declare that the information furnished above is true and correct to the best of my\n\t\t\t\tknowledge and belief. I understand that any false statement made herein may render my\n\t\t\t\tapplication liable for rejection\/cancellation and I agree to abide by the Bank's rules\n\t\t\t\tgoverning passbook issuance, replacement and updation, including the applicable fee.\n\t\t\t<\/p>\n\t\t\t<button type=\"button\" class=\"pba-btn pba-btn-secondary\" id=\"pba-declaration-close\">Close<\/button>\n\t\t<\/div>\n\t<\/div>\n\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-87","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/gpswebregistrar.com\/index.php?rest_route=\/wp\/v2\/pages\/87","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/gpswebregistrar.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/gpswebregistrar.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/gpswebregistrar.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/gpswebregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=87"}],"version-history":[{"count":2,"href":"https:\/\/gpswebregistrar.com\/index.php?rest_route=\/wp\/v2\/pages\/87\/revisions"}],"predecessor-version":[{"id":90,"href":"https:\/\/gpswebregistrar.com\/index.php?rest_route=\/wp\/v2\/pages\/87\/revisions\/90"}],"wp:attachment":[{"href":"https:\/\/gpswebregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=87"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}