VENDOR REGISTRATION FORM

COMPANY / FIRM / PROPRIETOR NAME

DIRECTOR / PARTNER / PROPRIETOR NAME

COMPLETE ADDRESS WITH PIN CODE

ADDRESS OF AREAS OF OTHER OPERATIONS

NAME OF CONTACT PERSON

CONTACT NUMBER

EMAIL ID

PAN NUMBER (Enclose Copy)

TAN NUMBER (Enclose Copy)

GST NUMBER (Enclose Copy)

MSME (YES/NO)

MSME NUMBER (IF Applicable - Enclose Copy)

PF NO (IF APPLICABLE)

COMPLETE BANK DETAILS

BANK NAME

ACCOUNT NUMBER
IFSC CODE (enclosed cross
cheque/passbook copy)

Declaration:That we will indemnify M/s _______________________________Limited for any loss (including but not
limited to tax, interest, penalty, legal costs, etc.) incurred by it on account of any misrepresentation made by us
through this declaration.
Signature : Stamp:
SIGNATURE WITH SEAL

VENDOR CODE NO:

Category - Raw Mat., Stores, Contracor, Transporter, Project etc.

Date Of creation:
Requisition Department:
For Office Use Only Created By (Name With designation):

Signature :

Approved By (Name With Designation)

Signature :