Dealer Registration Form

BUSINESS CONTACT INFORMATION

Title *
Company Name *
Phone | Fax *
E-mail *
Registred Company Address City, State Zip Code *

Date Business Commenced

Type of Business *

Photo

BUSINESS CONTACT INFORMATION

GST No: (Attach copy) *
Bank Name: *
PAN No: (Attach copy) *
Account Number: *
BANK STATEMENT LAST 3 Months (Attach Copy)
Type of Account: *
SECURITY CHEQUE NO. *

PERSONAL INFORMATION FOR ALL DIRECTORS AND PARTNERS

Name of Proprietor
Name of Proprietor
Address
Address
PAN NO.
PAN NO.
Aadhar no.(Attach copy)
Aadhar no.(Attach copy)
Date Of Birth
Date Of Birth

BUSINESS/TRADE REFERENCES

Company Name.
Phone.
Address.
Fax.
City,State ZIP Code.
E-mail.

SET LOGIN DETAILS

Username(Email) : *
Password: *

AGGREMENT

  1. All Invoices are to be paid 21 days from the date of the invoice.
  2. Claims arising from invocies must be maid within seven working days.
  3. By Submitting this application, you authorised UNIWORLD VISION PVT. LTD. to make inquiries into the banking and business/trade refrences that you have supplied.
  4. We Agree to accept the Credit Limits as sanctioned to us and will abide with your credit policy.
  5. We shall provide security and PDC before each Billings as per UNIWORLD VISION PVT. LTD. policy.
  6. We agree to pay interest on delayed payment @24% P.A. and cheque return charges Rs.500/- per return instrument.

Declaration: I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it.