SRMB Udyog Limited


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	Please use the below form to Apply for Distribution / Dealership.
	Fields with * are mandatory.

Please select your choice: *

Name of the Firm: *

Address: *

Status of the Firm:

Name of Proprietor/Partner/Director: *
(as the case may be)

Address of Proprietor/Partner/Director: *
(as the case may be)

(PIN)

Telephone/Fax: *

Phone: STD code:

Mobile: Fax:

Year of Establishment

Address of Shop *

Address of Godown *

Details of Bankers *

Name of Bank:

Address:

A/c No.:

Details of Securites viz Bank Guarantee

Details of Vehicles owned (If any)

District(s) where Distributorship wanted *

Details of Storage facility *

Covered Stock Yard Area: (Sq. Mtrs)

Godown Capacity: (Metric Tones)

Details/Distributor of any other (Presently Appointed)

(Company)

(Goods/Brands)

(Quantity)

(Value)

Expected Monthly Sale
(SRMB Product)

Sales Tax Reg. No. *

(State)

(Central)

(TIN)

Referee

Occupation	Name	Address & Tel no


Note: Referee of present company for the Dealer/Distributor is working will be preferred

Scanning

Note: Documents to be produced (As the case may be)
(a) Trade License
(b) Copies of Balance sheets of past 2 years
(c) Copy of Sales Tax Registration
(d) Banker's Certificate
(e) Copy of Memorandum and articles of association/Partnership deed
(f) Site Plan with approximate distance from nearest town