1) Name of the Organization:

2) Address:

3) Date of establishment:

4) Name/s of Proprietors/ Partners / Directors:

5) Telephone Nos. / Office: Res.:

Mobile: Fax.:

E-Mail

6) Office Space: sq. ft.

7) Show room : sq. ft. / Godown Space :sq. ft.

8) Name of the Bankers & Address:

9) Present Agencies for representation / selling:

Name of the Company & address	Products handled	Types of industries	Area/Towns covered for this company	Turn-over for this Company	Agency since which year

10) a) Are you manufacturing any items? (YES/NO)

      b) If yes, since when:

        -Type & products made:

        -Turnover : This year:Last year:

        - Markets covered:

      c) Are you reselling to shops? YES/NO, If yes, which type?

Number of such shops:

11) Whether you are planning following functions through own staff (YES/NO)

Sales:After Sales Service:

12) State: VAT No.: TIN No.: GST No.

13) Types of Vehicles in possession: 2 Wheeler:Cars:Tempo/Truck:

14) Area desired by you i.e. State/District/City. Please specify names:

15) No. of customers presently in your service: (Please underline / tick industries where you have made maximum turnover)

		Presently covered	Additional ones you can cover
1	Textile Mills & Process Houses
2	Plastic Processors
3	Food Processing Units
4	Paper Mills / Stationery mfg. units
5	Cosmetics
6	Consumer Products (Pl. specify)
7	Dyes / Paints
8	Engg. Products (Pl. specify)
9	Pharmaceutical mfrs.
10	Electrical Products
11	Electronic Products
12	Dairy Products
13	Automobile / Ancillary
14	Institutions (Tech. / Educational)
15	Chemicals / Fertilizers
16	Petrochemicals
17	Refineries
18	Marine
19	Sugar
20	Railway
21	Defence
22	Steel Plants / Forging Units
23	Non-Ferrous Metals Mfg.
24	Large Fabrication Shops
25	Pressure Vessel / Pipe Mfg.
26	Power Stations
27	Construction Co./ Consultants
28	Inspection Agencies
29	Shops
30	Gear Boxes
31	Wind Mills

Submit