Company Name :

Office Address :

Billing Address :

Phone / Fax No. :

Email Id :

Type of Company : ---Select Type of Company--- Partnership"; Proprietary"; Pvt. Ltd."; Public Ltd."; Others";

Pan No :

GST No :

Attach Appropriate File(s) : (* pdf file(s) only)

Name :

Residential Address :

% of Ownership in Business :

Mobile No. :

Telephone :

Account No :

No. Of Signatories :

Type of Account : ---Select Type of Account--- Cash Credit"; Over Draft"; General";

Bank Limits: Cash (OD)/ Credit :

L/C Limit :

Attach Bank Proof : (* pdf file only)