Please fill this form in ENGLISH and in BLOCK LETTERS
This information is sought under
A. Identity Details
6. Add MSME certificate in form of PDF.
8. Details of Partner/ Director
9. Bank Details
Add cancel cheque in form of PDF.
Add bank statement in form of PDF.
10. Details of Dealership (if any )
B. Address Details
3. Contact Details
C. Contact Details of Key Person
7. Permanent Address of Resident of Key Person
8. Proof of address to be provided by Applicant for Key Person. Please submit ANY ONE of the
following valid documents & tick against the document attached.
D. Other Details
Any Suggestion, Please Mentioned
DECLARATION
I hereby declare that particulars given herein are true, correct and
complete to the best knowledge and belief. I hereby agree to provide any additional information /documents
that may be required by the company.
SIGNATURE OF APPLICANT
CHECKLIST
(Before submitting this form, please go through the following checklist)
1. Please ensure that the form is completed in all respects and signed by you.
2. Please affix your recent photograph and sign across the photograph.
3. Please attach your PAN card as proof of Identity Document. This should be a photocopy
4. Please attach your Copy of GST Registration Certificate. This should be a photocopy
5. Please attach a Proof of Address Document
6. Photo of Key Managerial Person in front of GST Registered office
7. Please attach Bank Statement 03 months
8. Please attach MSME Certificate (If Registered)
9. Addtional Place of Supply
10. Electricity Bill
11. Godown Image