Application for the Appoitment of Distributors for Marketing of ITI Face Shields
Name of the Firm:
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Postal Address for Correspondence:
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Contact person:
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Phone:
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E-mail ID:
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Company Web Site:
PAN No:
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GST Details:
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Nature of Business & experience (Attach brief and upload):
Key Customers (Attach details/ Certificate):
Key Brands Distributed:
States / District operated:
Experience in distributing COVID 19 Related safety gadgets:
Do you have own fleet for distribution (Attach distribution methodology):
Payment Option:
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-Select Option-
UTR
DD
Payment Details , UTR NO/ DD No:
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