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Supplier Registration Form

If you are a Supplier please complete the form below:

Name of the Company*
Please Enter Name of the Company ! ! !

Location

Registered Office
Registered Office Address *
Please Enter Registered Office Address ! ! !
Telephone No. *
Please Enter Telephone No. ! ! !
Fax
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Email ID *
Please Enter Correct Email ID ! ! !
Corporate Office Address
Corporate Office Address *
Please Enter Corporate Office Address ! ! !
Telephone No. *
Please Enter Telephone No. ! ! !
Fax
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Email ID *
Please Enter Correct Email Address ! ! !
Sales Office Address
Sales Office Address *
Please Enter Sales Office Address ! ! !
Telephone No. *
Please Enter Mobile Number ! ! !
Fax
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Email ID *
Please Enter Correct Email Address ! ! !
Works Address
Works Address *
Please Enter Works Address ! ! !
Telephone No. *
Please Enter Correct Mobile Number ! ! !
Fax
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Email ID *
Please Enter Correct Email Address ! ! !
Authorized Stockiest / Agents Address
Authorized Stockiest / Agents Address *
Please Enter Authorized Stockiest/Agents Address !!!
Telephone No. *
Please Enter Mobile Number ! ! !
Fax
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Email ID *
Please Enter Correct Email Address ! ! !
Name and Designation of key officers art all the locations, including chairman and Managing Director, Vice Chairman, Works Manager, Sales Manager, Purchase Manager, Manager Quality Control etc.*

Please Enter Details ! ! !
Product Range *

Please Enter Product Range ! ! !
Product-wise name of major customers *

Please Enter Product-wise name of major customers ! ! !
Description of Quality System *

Please Enter Description of Quality System ! ! !
Important Raw materials used and their sources *

Please Enter Important Raw materials used and their sources ! ! !
Future Plans

Please Enter Future Plans ! ! !
Manufacturing Facilities / Equipment details *

Please Enter Manufacturing Facilities / Equipment details ! ! !
Laboratory and testing Facilities *

Please Enter Laboratory and testing Facilities ! ! !
Installed capacity and actual production during last 3 years *

Please Enter Installed capacity and actual production during last 3 years ! ! !
Financial Data for last 3 years First Year Second Year Third Year
Turnover in Rs. *
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Capital employed in Rs. *
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Earning before Interest and Tax *
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Profit after Tax. *
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Quality certificates held by you, awards received and efforts being taken by you for continual improvements. Please attach certificate issued by Pollution Control Board if applicable.

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Registration details
Bankers Name *
Please Enter Bankers Name ! ! !
Excise Details *
Please Enter Excise Details ! ! !
Range *
Please Enter Range ! ! !
Collectorate *
Please Enter Collectorate ! ! !
VAT Regn. No. *
Please Enter VAT Regn. No. ! ! !
Other Details if any *
Please Enter Other details if any ! ! !
Income Tax No. *
Please Enter Income Tax No. ! ! !
Excise Control Code *
Please Enter Excise Control Code ! ! !
Division *
Please Enter Division ! ! !
Regn. No. *
Please Enter Regd No.! ! !
CST Regn. No. *
Please Enter CST Regdn. No. ! ! !
PAN No. *
Please Enter PAN No. ! ! !
  

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