Vendor Registration Form

Company / Firm Name ^*

Email address ^*

Address ^*

Country ^*

State ^*

City ^*

Pincode ^*

Fax No

Website

Name of the contact person(s) ^*

Mobile no ^*

Telephone contact person

Type of Firm ^*

Pan No*

GST Registration Type ^*

Un-Registered

Regular

Composition

GST Number

GST Date (dd/mm/yyyy)

PF ^*

Yes

No

PF Details

ESIC

Yes

No

ESIC Details

Empaneled Vendor ^*

Yes

No

NSIC ^*

Yes

No

Owned by Women Entrepreneur ^*

Yes

No

GeM ^*

Yes

No

Product

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