(Note: All Fields marked with "*" are compulsory)

Company Name*
Address*
E-mail
Telephone*
Nature of Business*	Manufacturing         Dealer        Selling Agent        Engineering
Product / Service*
Type of Industry*
SSI Regn. No.*
D.G.S & D Regn. No.*
S.T. Regn. No.*
C.S.T. Regn. No.*
Year of Commencement of Business
List of Plant & Machinery
Name of reputed Customer
Annual Turnover, last Year
Borrowing limit from Bank if any
Existing / New Supplier
Supplier Code, if any
Whether inspection of Supplier Premises either by Purchaser or its Customer Shall be allowed?
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