For Dealer Enquiry : 9506034664

Dealers Form

Dealers-Form

* अनिवार्य फिल्डस (Mandatory fields)
Firm Details
Firm Name
Firm Address
Name of the Place where Dealer ship is required
City Name / Location
State
District
Approximate population of the place (where Dealer is required)
Nearest railhead and the distance from railway Station to our warehouse. :
Road distance from factory to the place of business.
Proposed quantity to be sold every month:
Name and address of the Directors (in case of Limited Co.) :
Name and address of the Partners/ Proprietor (in case of sale proprietary concern) :
Year of Establishment:
Contact Details
Mobile Number
Email Address
(e.g.abc@yahoo.com)
Address Details
Address Line1/पता पंक्ति 1 *
Address Line2/पता पंक्ति 2
State
District
Pin Code / पिन कोड *
Bankers Name & Address
TIN No. (State)
TIN No. (Central)
PAN No.
Details of other Business
Details of Godown and own transport facility
Annual Turnover
Any other important particulars
If yes photocopy of the registration cel1ificate to be enclosed
( JPG,JPEG,GIF,PNG image with size upto 50 KB )
6. Declaration
I/We declare that to the best of my/ our knowledge the information furnished above are true and complete.
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