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SUMISHA EXIM PVT LTD

V.R Form No. _____________

IMPORTANT INSTRUCTIONS

1.	The V.R. Form is to be completed in all respects. If any item is not relevant, please write “Not Applicable”.
2.	Submission of incomplete application/short receipt of documents shall be sufficient cause for outright rejection and no further correspondence shall be entertained.
3.	Quote V.R. Form No. in all future correspondences
4.	Enclose all relevant documents.
5.	Do not enclose any other document unless specially asked for.
6.	Each page of the V.R. Form to be duly signed at the bottom.

FOR OFFICE USE ONLY

V.R. Form No. ___________________________________________________

Date of issue of V.R. No. ____________________________________________

V.R. Form Received From _________________________________________________________________________________

Name _________________________________________________________________________________________________

Signature & Date ________________________________________________________________________________________

Designation _____________________________________________________________________________________________

VENDOR REGISTRATION FORM

NAME OF THE ORGANISATION :*

TYPE OF WORK FOR WHICH REGISTRATION IS SOUGHT :

DATE OF START OF BUSINESS :

TIN NO & DATE :

CST NO & DATE :

EXCISE REGISTRATION NO. & DATE :

SERVICE TAX NO. & DATE :

PAN NO :

BANKER INFORMATION

BANKERS NAME :

ACCOUNT TYPE & NO. :

BANK BRANCH :

BANK ADDRESS :

RTGS / NEFT / IFSC CODE :

NAME & TELEPHONE NO. OF CONTACT PERSON

(A) HEAD OFFICE / REGISTRED OFFICE / ADDRESS


CONTACT PERSON :

EMAIL ID :*

TELEPHONE NO. :

FAX NO. :

MOBILE NO. :

(B) BRANCH OFFICE / WORK SHOP, IF ANY ADDRESS


CONTACT PERSON :

EMAIL ID :

TELEPHONE NO. :

FAX NO. :

MOBILE NO. :

NAME OF CHIEF EXECUTIVE / PROPRIETOR/PARTNERS/M.D.

EMAIL ID :

TELEPHONE NO. :

FAX NO. :

MOBILE NO. :

TYPE OF ORGANISATION

PROPRIETARY	PARTNERSHIP

PRIVATE LIMITED COMPANY	PUBLIC LIMITED COMPANY

PUBLIC SECTOR

SISTER CONCERN / OTEHR GROUP OF COMPANY?

YES	NO

Company 1:-
Company 2:-
Company 3:-

ARE YOU A SSI / NSIC INDUSTRY?

YES

ANNUAL TURNOVER DURING LAST 3 YEARS :

Year	Turnover in Lakhs (Rs)

a)

b)

c)

d) Current Year (estimated)

PERSONAL INFORMATION OF OWNER :

NAME OF THE OWNER / PARTNER / M.D. :

RESIDENCE ADDRESS :

DATE OF BIRTH :

RESIDENCE TEL NO. :

EMAIL ID :

REFERENCE OF DISTRIBUTOR / PARTIES :

NAME :

ADDRESS :

CONTACT PERSON :

TELEPHONE NO. :

____________________

Signature of Vendor

DECLARATION BY VENDOR

I confirm that ,

i) The information furnished are correct to the best of my knowledge and belief.

_____________________________________

(Signature of Proprietor/Partner/Chief Executive)*

Name _________________________________

(in Capital Letter)

Place : ________________________

Date : ________________________

(Seal of Vendor)

Strike out those which are not applicable.

LIST OF DOCUMENTS REQUIRED

1)	Sales tax / Service Tax Registration Xerox copy
2)	PAN Card Xerox copy
3)	Excise Registration Xerox copy

Contact Us : 101, Anand Mangal-3, Prema Arcade Lane, Next to Ambawadi Municipal School, Nr.Parimal Garden, Ellisbridge, Ahmedabad-380006. (INDIA)