Distributor Registration

Re Distribution Stockist Form

	I	II	III
i. Name
ii. DATE OF BIRTH
iii. MARRIAGE ANNIVERSARY DATE
iv. DESIGNATION
v. RESIDENTIAL ADDRESS


vi. PIN CODE
vii. PHONE NO.(R)
viii. MOBILE NO.
ix. E-MAIL

C. NAME OF MAIN DEALING PERSON : STATUS :
3. A. YEAR OF STARTING BUSINESS :
B. NO. OF EMPLOYEES :
C. SALES TURNOVER OF LAST THREE YEARS : YEARS:
TURNOVER IN RUPEES (LACS) :
D. NATURE OF BUSINESS (MENTION NAMES OF EXISTING AGENCIES):
4. A. INVESTMENT WE WILL MAKE IN THE COMPANY BUSINESS : Rs.
B. MONTHLY TURNOVER ASSURED FOR COMPANY PRODUCTS: Rs.
5. DELIVERY ARRANGEMENTS : TYPE OF VEHICLE : I. II. III.
REGISTERATION NO.:

OWNED BY:

6. BANKERS:

NAME & ADDRESS	A/C No.	IFSC CODE
A.
B.

7. PARTICULARS OF SISTER CONCERNS/BRANCHES, IF ANY:

8. PARTICULARS OF ANY OTHER RELATIVE / ASSOCIATE WORKING WITH OR HAVING BUSINESS DEALING WITH THE CO.

NAME	ADD. & TEL. NOS.	HOW RELATED	NATURE OF BUSINESS	SINCE

9. NAMES OF SUGGESTED TRANSPORT COMPANIES: (Subject to clause 5 of terms & conditions Overleaf.)
A.

B.
10. A. GST IN.: * DATED: (Duly Attested Photocopy Enclosed)
B. LOCAL SALES VAT NO.: DATED: (Duly Attested Photocopy Enclosed)
B. CENTRAL SALES TAX NO.: DATED:(Duly Attested Photocopy Enclosed)
C. TAX PAYER IDENTIFICATION NO. (T.I.N) DATED:(Duly Attested Photocopy Enclosed)
D. PERMANENT ACCOUNT NO. (P.A.N) DATED:(Duly Attested Photocopy Enclosed)
11. CLOSED DAY OF THE WEEK :
12. A. POPULATION OF TOWN / AREA: (lacs), B. DISTRICT: (lacs)
C. NO. OF RETAILERS IM THE TOWN / AREA DEALING IN SOAPS / DETERGENTS:
13. SECURITY PAID: Rs. BY CASH/DEMAND DRAFT NO./UTR NO.
DATED OF(BANK)