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SHRI ANANDPUR TRUST

VENDOR REGISTRATION FORM

Name of the Applicant:* :

Status (Choose one as applicable):*:

Name of Proprietor:* :

Father's Name:* :

Date of incorporation:* :

Place of incorporation:* :

Nationality:* :

Taxation Status:* :

Resident Individual Non-Resident Foreign National

Resident Non-Resident

Nature of supplies to SHRI ANANDPUR TRUST:* :

Sales Goods Services Work Contractor Labor Consulting Technical Services

Email:

Mobile No:

Name of Bank*:

Account Type *:

A/c No.*:

IFSC Code*:

Branch address*:

Country* :

State*:

City/town/village:* :

Pincode* :

Cheque:

Bank Confirmation

Registered Address*:

Country* :

State*:

City/town/village:* :

Pincode* :

Proof of registered address attachment:

To copy to Correspondence Address

Address*:

Country* :

State*:

City/town/village:* :

Pincode* :

Specify the proof of address submitted for correspondence address:

Proof of address attachment:

Pan# :

Pan# Image:

Is GST Applicable:

Yes No

GST* :

GST Certificate*:

Is Employee PF Applicable:

Yes No

Employee Provident Fund Registration No. *:

Employee PF Registration Certificate *:

Is ESIC Registration Applicable:

Yes No

ESIC Registration No. *:

ESIC Registration Certificate *:

Is Shop and Establishment Applicable:

Yes No

Shop and Establishment Registration No. *:

Shop and Establishment Registration Certificate *:

Is MSME Applicable:

Yes No

Micro, Small & Medium Enterprises Registration No. *:

Micro, Small & Medium Enterprises Registration Certificate *:

MSME Type *:

Major Activity *:

I/We hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief and I/we undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am/we are aware that I/we may be held liable for it.

Signature of the Authorised:

Date: 19/05/2024

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SHRI ANANDPUR TRUST

VENDOR REGISTRATION FORM

Identity Details

Bank Details

Registered Address

Correspondence Address - (if different from Registered Address)

Other Details

Declaration