Declaration Letter For Vendor Registration

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(ON LETTER HEAD)

Name & Address of firm :______________________________________________


____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________

Contact Person(s) :______________________________________________
       ______________________________________________ 
                 
Contact Details : Tel.No. :______________________________________________
Mobile :______________________________________________
Fax No. :______________________________________________
Email :______________________________________________
PAN No.                  :______________________________________________
GSTN.              :_____________________________________________
Provident Fund No.    :_____________________________________________  
E.S.I.C No.                  : ____________________________________________
WCT Reg.No. : :____________________________________________
Profession Tax : ____________________________________________

Bank Details : Bank Name  :_____________________________________________


Account No. :_____________________________________________
Branch :______________________________________________
Address :______________________________________________

Name (Authorized Signatory/Signatories) :( 1) _____________________ Signature _____________

(2) _____________________ Signature______________

Title /Designation :__________________________________________________


:__________________________________________________

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For Company Profile

a) Nature of Business : - i.e. whether Stockiest, Agents, Traders, Manufacturing unit,


Dealers, Distributors or Consultancy

b) Industry segment : - i.e. whether small, mid or large scale or individual

c) Year of incorporation : -

d)       Ownership Information: - i.e. whether Proprietary, Public Ltd., Pvt. Ltd etc.

I hereby declare and confirm that the above mentioned details are true

(Name & Signature)


Date :

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