Postal address with Telephone, mobile, fax nos. and email ids
ABC
a ) Head Office/Registered Office
PQR
3 . Registration is sought as
MANUFACTURER
a ) Floor area of Factory (ies) in square meters
200
b ) No. of workers employed
10
c ) No. of staff employed
14
7 . Whether firm is ISO certified or any other certification, mention details and documentary evidence
8. Group of Items/service for which registration is sought <a href="sites/default/files/ANNEXURE_c.pdf" target="_blank">(Refer Annexure-C for Group details)</a>
III
a ) if a Limited concern, name & addresses of Directors & Managing Director
XYZ
Registered Options
(ii) The Indian Partnership Act, 1932.
12. Sales Tax Registration No. (attach copies of GST Certificates)
13. Are you registered under NSIC and submit NSIC registration as a proof
14 . Are you registered under MSME and submit “Udyam Registration Certificate” as a proof
15 . Are you on the list of approved/registered supplier in Dept. of Atomic Energy or any of its units/any Govt./Semi-Govt. dept./GeM (Govt. e-Market)
16 . Bankers Name, address, Account no
Declaration
| Sr. No. | Name | Position (Whether Proprietor, Partner or Share Holder) | Signature by all Partners/Competent Authority/Proprietor |
|---|---|---|---|
| 1 | XYZ | Proprietor | |
Place :
Ahmedabad
Signature with Official seal
Enclosure to registration form
| Brief description of materials for which registration is sought | Whether you are manufacturer, dealer or distributor or Stockiest. If Dealer/distributor give manufacturer’s territory represented | If Dealer/Distributor/Stockiest, Name and address |
|---|---|---|
| XYZ | XYZ | XYZ |
Upload duly signed and stamped letter containing above additional information