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Name of Firm *
Email Address *
Address *
Mobile No *
Web Site
Nature of Business (Please Tick any One) WholeselerTradersRetailer
Nature of Company (Please Tick any One) ProprietaryPartnershipPrivate Ltd.Public Ltd.Other
Size of the company
Year of establishment
Values of Investment in Plant and Machinery
Availability of Godown ( Area)
Distribution area
Total no of outlets covered
Enterprise Registration No
Date
Requested Location * AgraAligarhAllahabadAmbedkar NagarAmethi (Chatrapati Sahuji Mahraj Nagar)Amroha (J.P. Nagar)AuraiyaAzamgarhBaghpatBahraichBalliaBalrampurBandaBarabankiBareillyBastiBhadohiBijnorBudaunBulandshahrChandauliChitrakootDeoriaEtahEtawahFaizabadFarrukhabadFatehpurFirozabadGautam Buddha NagarGhaziabadGhazipurGondaGorakhpurHamirpurHapur (Panchsheel Nagar)HardoiHathrasJalaunJaunpurJhansiKannaujKanpur DehatKanpur NagarKanshiram Nagar (Kasganj)KaushambiKushinagar (Padrauna)Lakhimpur - KheriLalitpurLucknowMaharajganjMahobaMainpuriMathuraMauMeerutMirzapurMoradabadMuzaffarnagarPilibhitPratapgarhRaeBareliRampurSaharanpurSambhal (Bhim Nagar)Sant Kabir NagarShahjahanpurShamali (Prabuddh Nagar)ShravastiSiddharth NagarSitapurSonbhadraSultanpurUnnaoVaranasi
GST No *
PAN No *
Cin NO *
Date Of Allotment
Date Of incorporation
GSTIN Reg Certificate(50-150 kb Fille size limit) *
PAN Copy(50-150 kb Fille size limit) *
Certificate of Reg other(50-150 kb Fille size limit)
Bank Name *
Account No
Bank Address
IFSC Code
No.
Year
Production
Annual Turn Over
Filled Y/N
Ack No.
* Required
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