Vendor Registration Form

(Marked * : Mandatory Fields)

Entity Name (Use dropdown for response) Flipkart India Private Limited
If selected Multiple Entities
Nature of Business*
(Use dropdown for response)
If Others selected above, please detail
Vendor Name*
Alternate Vendor Name per Bank Details*
Contact Person*
Address*
Street
City
State
Country
Postal code*
Telephone
Fax
Mobile*
GST Reg. or Non-GST Declarared*
(Use dropdown for response)
Pan No*
E-mail*
Company Registration No*
Type of Category*
Micro, Small, Medium Enterprises Registration No.
(MSME) or Non-MSME Declaration*
Bank - Details
Account Holder Name*
Name of Bank
Branch
Street
City
Account No*
IFSC code*
Swift code(Mandatory for International Vendor)
Company - Details
Annual Turnover*

Client List - (Min - 3 MNC's)

References
Escalation Matrix Name Designation Contact No
Level 1
Level 2
Is the Supplier a Third Party Intermediary (TPI) as defined below:*
(Use drop down for response) : No

If the Supplier is a TPI, does the Supplier agreement include an Anti-Corruption clause:*
(Use drop down for response) :
No
Third Party Intermediary (TPI): A “Third Party Intermediary” (“TPI”) is a service provider, consultant, distributor, contractor, vendor, supplier, or
other third party, whether an individual or an entity, other than a Business Partner, engaged or retained to assist the Company in any function or
business that requires or involves interaction with any Government Entity or Government Official on behalf of the Company. A supplier of only
goods is not a TPI.
Note: Please get in touch with the Anti Corruption Team for any queries regarding TPI assessment.

Flipkart/F1& Jeeves Business Unit SPOC details

Employee Name* Anantha
Email Id* anantha.k@flipkart.com
Contact details* 8037786237
Approver Name*
(Manager & above)
Unit/Department* AR Finance
Email ID*
Contact details* 8037786237
Flipkart/F1& Jeeves Internal Business Unit SPOC details*
Responsible Business Unit SPOC Requestor/SPOC Authorized Signatory
Requestor/SPOC Approver (Manager & above)

Anantha 0
X

Supplier Authorized Seal & Signatory*

Supplier Authorized Seal & Signatory

 Supplier Authorized Seal & Signatory
Mandatory Documents*
Attach the copies of all the below mentioned mandatory documents:
1) Bank Statement or Cancelled Cheque or Bank Letterhead or Bank Passbook
2) ROC Certificate/Registration Document
3) PAN Card
4) GST Certificate
5) Agreement with the vendor for Non PO Based Vendor onboarding
6) VRF should be shared back in PDF format updated with all mandatory fields.