BIGBLOC CONSTRUCTION LIMITED

CIN NO. L45200GJ2015PLC083577

Regd. Office: 6th Floor, A-601/B, International Trade Centre, Majura Gate, Ring Road, Surat 395002
Tel No: 0261-2463261/62/63, E-mail ID: contact@nxtbloc.in
Dealer KYC Form

Name of the Firm/Company/ Proprietor (Full

legal entity name) :

Type of Firm Proprietor / Partnership / LLP / Pvt. Ltd Company / Public

:
Ltd. Company
Address of the Firm/Company/ Proprietor (Full
legal entity name)
:

Status of Address of Firm : (A) Own (B) Rental

Date of Establishment of business :
Income Tax PAN :
Corporate Identification Number (CIN No.) :
GST Number :
Aadhar Card Number of Authorised Person/
Director/Partner/Proprietor :

Current Business Line

:

Correspondence Address:
Plot/Flat/Unit No. & Floor :
Name of the Premises :
Road :
Taluka / Locality :
District :
State :
Pin Code :
Contact Number :
e-mail ID :

Address for Place of Supply of Goods & Services:

Plot/Flat/Unit No. & Floor :
Name of the Premises :
Road/ Landmark :
Taluka / Locality :
District :
State :
Pin Code :
Contact Number :
e-mail ID :
GST Number :
 BIGBLOC CONSTRUCTION LIMITED
CIN NO. L45200GJ2015PLC083577
Regd. Office: 6th Floor, A-601/B, International Trade Centre, Majura Gate, Ring Road, Surat 395002
Tel No: 0261-2463261/62/63, E-mail ID: contact@nxtbloc.in
Dealer KYC Form
Bankers Details
Name of the Bank :
Branch Address (With PIN Code) :
IFS Code :
RTGS Code :
NEFT Code :
Account Type :
Account Number :

Details of the Sales/Service/Contract Authorised Person:

Name :
Residential Address :
Mobile Number :
e-mail ID :

Documents to be attached : Whether Attached (Yes OR No)

Certificate of Incorporation/ MOA & AOA of
Company
PAN Card of Firm/Company/Partnership
Firm/Proprietorship
Aadhar Card Number of Authorised Person/
Director/Partner/Proprietor
GST Registration Certificate
Address Proof (Rent Agreement/ Utility Bill/
Govt. approved certificate & license)
Cancelled Blank Cheque
Last 6 months Bank Statement or Last 6 month
GST Return
Last 2 Years Financial Statements (Balance
Sheet) along with ITR
Blank Security Chaque
NOTE:- Please attach relevant documents.

The above particulars are true to the best of my knowledge and belief. Any change in the information will be
intimated to you.
Date:

Place:

(Signature of Proprietor/ Partner/ Director) with stamp/ Seal of Firm

Name & Designation

Office Use Only
Approved By : Name & Sign :
Date : :
Place: :
: