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Dealer Evalution Form-New

This document contains a dealer registration form for Compuage India, along with instructions for internal use. It requests information such as the applicant's organization details, address, sales tax and PAN numbers, financial details, bank account information, and enclosures required. The form is to be signed by the proprietor, partner or director. For internal use, spaces are provided to record the sales person's name and code, recommended credit amount and terms, customer type, and signatures from the branch and zonal managers.

Uploaded by

Sathyavageeswaran Padmanabhan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
84 views4 pages

Dealer Evalution Form-New

This document contains a dealer registration form for Compuage India, along with instructions for internal use. It requests information such as the applicant's organization details, address, sales tax and PAN numbers, financial details, bank account information, and enclosures required. The form is to be signed by the proprietor, partner or director. For internal use, spaces are provided to record the sales person's name and code, recommended credit amount and terms, customer type, and signatures from the branch and zonal managers.

Uploaded by

Sathyavageeswaran Padmanabhan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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For Internal Use Only

CIL Location ________________


Mbai-400 007.
Tel:
Code
022-67291300
Allotted:

Lotus Corporate Park, D Wing 601,602,602G,


Graham Firth Steel Compound, Western Express
Highway, Goregaon (East) ,
Mumbai-400 063.
Tel: 022-67114444 FAX NO. 022-67114445

_______________

Date of Registration: __________

E-mail: info@compuageindia.com
Website: www.compuageindia.com

DEALER REGISTRATION FORM


Please Stable
two Recent PP
Size Photo of
Prop/Partner/
Directors with
Name Written
on the backside
of the Photos.

Please Stable
two Recent PP
Size Photo of
Prop/Partner/
Directors with
Name Written
on the backside
of the Photos.

Type of Organisation: - Proprietor / Partnership Firm / Private Ltd. / Public Ltd.


Name of the Organisation: - M/s. __________________________________________________________
Registered Office: -

City: Phone No. : -

Branch Office:-

State:Mobile No. : -

Fax No. :-

Email :Premises Details: Owned / Rented / leased No. of Years

Area

Sq Ft.

Sales Tax LST / TIN: - _____________________________ CST: - _______________________________


PAN No. :- ____________________________
Name and Residential address of the Prop. / Partner / Director
(Please attach separate sheet, if more than two)
1) _______________________________________ 2) ______________________________________
_______________________________________ _______________________________________
Phone: - _______________________

Phone
1

: - ___________________

Passport No: - __________________

Passport No: - ___________________

Business Profile: - No of years in IT Industry _________ Year. None ITS Industry ___________ Year.
Products Currently
Dealing In
Procured

Credit
Amount (In Lacs)

No. of Days

Financial Details: A) Capital Employed ________________ B) Average Inventory _________ (Lakhs)


C) Turnover (Last Fin Year): ITS Industry _________ (Lakhs) Non ITS Industries ________ (Lakhs)
D) Name & Address of the Bankers: - _________________________ E) Account No: - _________
F) Type of Facility Enjoyed with the Bank: - OD ______________ (Lakhs) / CC ____________ (Lakhs)
Declaration:Mr. / Ms. _______________________ The, Proprietors / Partner / Director of M/s. ______________
do hereby declare that the particulars furnished above are true and correct to the best of my Knowledge
And belief.
Date:

Place:

Signature & Seal

Enclosures: - (Please Put Tick Mark)


1) Memorandum & Articles of Association / Partnership Agreement

3) Copy of Passport- Proprietors / Partner / Directors

2) CST & LST Registration proof

4) Proof of Income Tax PAN

5) Latest Audit Accounts with Income Tar return Acknowledgement copy


6) Bank Statement of the Previous 6 Months.
7) Photograph of Proprietors / Partner / Directors
FOR INTERNAL USE ONLY:CIL Sales Person Name: - _____________________ Code: - ______________ Sign:-__________
If Credit, Amount of Credit recommended: ______________ (Lakhs) ______________ (Days).

Customer Types:- (Tick from Below)


(1) Sub Distributor (2) System Integrator/Network Integrator (3) Reseller (4) PC Assembler (5) IT Retail
(6) Large Format Retail (7) CE Retail (8) CE Channels (9) Telecom Retail (10) Telecom Channel
(11) OEMs-IT (12) OEMs UPS.

Date:

Signature of Branch Manager

Remarks of ZM: Date:

Signature of Zonal Manager

Lotus Corporate Park, D Wing 601,602,602G,


Graham Firth Steel Compound, Western Express
Highway, Goregaon (East) ,
Mumbai-400 063.
Tel: 022-67114444 FAX NO. 022-67114445
E-mail: info@compuageindia.com
Website: www.compuageindia.com

CHANNEL MASTER DATA UPDATE

Branch Name :

Please Staple Two Passport Size Photo of the


Authorised Persons (Prop. / Partner / Directors)

Branch Code :
Name & Address:

Name of the Proprietors / Partner / Directors : 1._______________________________________


2. ______________________________________
3. ______________________________________
LST / CST Nos. with area code

: ________________________________________
________________________________________

Pan No. (Proprietors / Partner / Directors): ___________________________________________


Email Address of:
Proprietors / Partner / Directors / Company : 1. _______________________________________
Telephone Nos. Office-(With area code)

: ________________

Name and Residential Address of the Proprietors / All Partner / Directors with Telephone Nos.
(Attach Separate Sheet, If Required)
1._______________________________________________________________________
_________________________________________________________________________
3

2.________________________________________________________________________
________________________________________________________________________

Place:

Signature with Seal

Date:

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