1. Name of the Firm / Company*:

2. Full Address*:

3. Telephones*:

/

Fax*:

4. E-mail*:

5. Communication mode*:

Business

5. Address of Godown:

Warehouse:

Phone No

6. Branch Office if any:

7. Established in*:

8. Sales Tax Reg. No. (MST-CST. (Certified xerox copies attached)*:

9. Income Tax PAN No.*:

10. Name of the Bankers:

11. Constitution - Whether Proprietary or Partnership or Pvt. Ltd. Or Limited (Attached Partnership Deed / Article of memorandum)*:

12. Trade Information*:
i. The Exact Nature of Business
ii. The Items Dealt In

13. Name & Residential Address of the Proprietor / Partners / Directors* (Atleast 1):

a. Name in Full

Address

Telephone

Mobile

DOB

E-mail

b. Name in Full

Address

Telephone

Mobile

DOB

E-mail

c. Name in Full

Address

Telephone

Mobile

DOB

E-mail

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