Customer Registration Form

Company Details
Please mention "Not Applicable" in the column where details not available to mention.
Correspondence Address ( Delivery Address )
Statutory Details
Name & Designation of Principal Officers/Persons to be contacted
Promoter/Director >>
Sales >>
Dispatch >>
Stores >>
Purchase >>
Accounts >>
Nominated Transporter
Nature of Business (Please Tick any One)
» Manufacturing
» Sole Selling Agent
» Dealer
» Agent
» Assembler
» Trader
Nature of Company (Please Tick any One)
» Proprietary
» Partnership
» Private
» Public Ltd.
Bank Details
The above information is true in all respects and we undertake to inform you if any change in the above particulars regarding our business from time to time.