Dealer :

Firm Name*

GST No.*

PAN No.*

Nature/Type of Concern

Nature/Type of Business

Mobile No*

Email ID

Date of Birth

Proprietor/Partner Name

Designation

Official Address

City

State

Residential Address

Present Business Activities

Market Area's Covered

Present Infrastructure (Storage Space, Delivery Vehicles, Manpower, etc.)

Investing Capacity (In Rs. Lacs)

Annual Sales Turnover (in Lacs)

Weekly Off of Market

Market Area's Covered

Activities of Sister Concern

Preferred Transport

Sister Concern (Firm Name)

Numbers of Retailers Catered (by visit)

Details of agency of other brands that you are involved it

Interested in Products

Agarbatti

Dhoop

Camphor

Puja Samgari

Export Products

Remark

Copy of GSTN Max file size 10MB.

Copy of PAN Card Max file size 10MB.

Any Photo id of Key Person (Adhaar Card, Driving License, Passport and Voter Id) Max file size 10MB.

I/We Hereby agree that all above information are true & correct. We also accept all terms & conditions above & are ready to work with you

BECOME A Dealer