DEALERSHIP APPLICATION FORM

DEALERSHIP APPLICATION FORM

DEALERSHIP APPLICATION FORM

Name of the Applicant:

Name of the Firm/Shop:

Address Of the Firm:

Phone No. (With STD code):

Mobile No:

Email:

Details of Bank A/c. :

Name and address of Bank:

Type of A/c. (tick ):

Savings Current Others

Account No:

Name of authorized signatory:

Name of firm/company under which dealership exist :

Company Name:

Products:

Quantity:

Remarks:

Company Name:

Products:

Quantity:

Remarks:

Company Name:

Products:

Quantity:

Remarks:

Status of firm (tick ):

Proprietorship Partnership Limited Company Private Ltd. Co

(For partnership firms enclose copy of partnership Deed for Companies Memorandum Articles of Association)

Details of Proprietor/Partners/Directors:

Name:

Date of Birth :

Father’s/Husband’s name:

Marital status:

Name:

Date of Birth :

Father’s/Husband’s name:

Marital status:

Name:

Date of Birth :

Father’s/Husband’s name:

Marital status:

Name and address of associate firm(s):

Turnover:

Details of Security Deposit:

DD/Cheque No.:

Date:

Amount:

Bank:

Payable at:

Referred By:

Attach your photo

Attach valid Photo ID

DEALERSHIP APPLICATION FORM