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CUSTOMERS REGISTRATION
Dear customer,
Kindly fill in the following details about your esteemed organization for the updation of our database. We assure you that all information provided by you shall be kept confidential.
 
   CUSTOMER REGISTRATION FORM
Category (Manufacturer / Trader / Dealer etc.)
Major Product / Service
 
   GENERAL INFORMATION
Name of The Customer
Name of The Promoter
Date of Incorporation
Status of The Customer (Properietory / Private Limited / Partnership / Public Limited / Others)
ADDRESS FOR CORRESPONDENCE  
House Number & Street
City
Postal Code
State
Telephone Number
Fax Number
 
REGISTERED OFFICE  
House Number & Street
City
Postal Code
State
Telephone Number
Fax Number
FACTORY / WORKS  
House Number & Street
City
Postal Code
State
Country
Telephone Number
Fax Number
Company Website
 
CONTACT PERSON DETAILS  
Name
Department
Designation
Mobile Number
E-Mail Id
Alternate E-Mail Id
 
 
   TAXATION DETAILS    BANK DETAILS
Income Tax Number (Pan)
Excise Registration Number
Excise Range
Excise Division
Excise Commissionerate
Tin Number
Vat / Cst Number
Service Tax Registration Number
Banker's Name
Bank Branch
House Number & Street
City
Postal Code
State
Bank Account Number
IFSC Code (Please get this code from your bank branch) ( 11 Digit)
 
   FINANCIAL DETAILS    REFERENCES
Financial Year  
2006-07
2005-06
2004-05
* Kindly specify the figures in INR Crores and enclose the audited financial reports for the same.
List Your Top Five Clients
 
 
 
 
Are You A Customer/Vendor To Any Of The Vedanta Group Companies? (Yes / No) (If yes, please enclose the order copies)
 
   OTHERS  
Is any of your relatives working in one of the Vedanta Group Companies? (Yes / No)
If yes, kindly provide the following details  
Name
Designation
Company
Location
 
 
I / We declare that the information furnished above is correct to the best of my / our knowledge.
I / We undertake to inform you at the earliest of any changes in the details mentioned above.
 
 
 
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