CLIENT REGISTRATION FORM

(***All fields are mandatory for on-boarding***)


COMPANY DETAILS
1. Entity Name
(as appears in GST certificate)		 DUMMY TEXT
2. Address Details
(Registered Office Address)		 DUMMY TEXT
3. Address Details
(Billing Address)		 DUMMY TEXT
4. Type of Business DUMMY TEXT
5. Nature of Work/ Business DUMMY TEXT
6. Company Registration Number DUMMY TEXT
7. PAN Number
(Not applicable for foreign entity)		 DUMMY TEXT
8. TAN Number
(Not applicable for foreign entity)		 DUMMY TEXT
9. GST Number
(Not applicable for foreign entity)		 DUMMY TEXT
CONTACT DETAILS
10.1 Company Website
(if any)		 DUMMY TEXT
10.2 Marketing Contact Name & Designation DUMMY TEXT
10.3 Marketing Contact Number DUMMY TEXT
10.4 Marketing Contact Email address DUMMY TEXT
10.5 Finance Contact Name & Designation DUMMY TEXT
10.6 Finance Contact Number DUMMY TEXT
10.7 Finance Email address DUMMY TEXT
INVOICING DETAILS
11. Invoicing Currency DUMMY TEXT
BANK/NEFT DETAILS
12.1 Bank Account Number DUMMY TEXT
12.2 Name of the Bank DUMMY TEXT
12.3 Bank Address DUMMY TEXT
12.4 IFSC Code DUMMY TEXT
12.5 IBAN #
12.6 Swift Code
DECLARATION
  1. I/We declare that all the information provided herein (including the enclosures) are true to the best of my/our knowledge:
  2. I/We declare that me/we are authorized to provide information for updating vendor database in company's records.
  3. The email-ids provided above are official and authorized. Any communication regarding creation/updation of details in Company's records including bank details, change in name/address, updating PAN and GST details etc. received from these email ids, as applicable shall be considered to be authorized by us and be taken on record and taken forward for further execution. We shall keep you informed as and when there is change in the aforementioned information. We shall indemnify company against all payments, claims, expenses, proceedings, actions, liabilities, losses and damages arising out of or in connection with any act or fraud or default or omission or negligence regarding communication from above e-mail ids and resultant actions.
Authorized Signatory
 
(Date & Signature)   (Name & Designation)   (Company Seal/Stamp)