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Details of Firm
Name Of The Firm
Type Of Firm (Please Tick)
Propreitorship
Partnership
Private Limited
Others
Nature Of Firm (Please Tick)
Institutional
Wholesaler
Distributor
Exporter
Others
Firm Address
City
District
Pin Code
Contact Person Details
Name
Telephone No.
Mobile No.
Email address*
Statutory Details
Fssai License No.
Date of Establishment*
GSTIN No.
PAN No.*
Distribution Details
No. Of Outlets Covered
No. Of Delivery Arrangements
No. Of Sales Staff
Registered In Modern Trade Stores (If Any, Specify Each)
Detail Of Infrastructure
Office(s) Size-Square Feet
Godown : Size-Square Feet
Situated (Please Tick)
Basement
Ground Floor
1st Floor
2nd Floor
3rd Floor
Products Currently Handled
S.No.
1.
2.
3.
4.
Brand/Product
Name Of The Company
Stockist, Distributor etc.
Area(S) Covered
Turnover Per Year
Any Additional Information you wish to give about your concerned market (In Brief)
Date
Signature of Party
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