Company Registration

Name of Company *

Office Address *

City *

District *

Telephone No 1 *0 / 10

Telephone No 20 / 10

Email Address *

Website

Type of Business *Corporate / LimitedPartnershipOther (specify)

Type of Business *

Business Registration No *

VAT Registration No

Delivery address different to the above *YesNo

Stores / Factory Address *

City *

District *

Contact Person *

Telephone No *0 / 10

Mobile No *0 / 10

Email ID

Primary Contact Person (Procurement) *

Designation *

Telephone No *0 / 10

Mobile No *0 / 10

Email ID *

Secondary Contact Person (Procurement)

Designation

Telephone No0 / 10

Mobile No0 / 10

Email ID

Payment Type *CashChequeOnline Transfer

Required Credit Period *Net 07Net 15Net 30

Primary Contact Person (Accounts) *

Designation *

Telephone No *

Mobile No *

Email ID *

Secondary Contact Person (Accounts)

Designation

Telephone No

Mobile No

Email ID

Upload the Business Registration Certificate *

No file chosen

Upload the VAT Registration Certificate

No file chosen

Consent *

I, the undersigned, warrant that the information provided in this form is correct, and in the event of changes details should be provided as soon as Possible.

Approval Person *

Designation *

Mobile No / Telephone No *

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