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Name of the Applicant *
Name of the Company/firm *
Enter email-id
Enter Mobile no
Enter Landline no
District *
State *
Address *
Do you have any experience of FMCG distribution / Wholesale distribution / Other distribution?
If you accept the above terms and conditions and is ready to give us all the information’s mentioned above then please attach your last year ITR (Income Tax Return) and balance sheets with this application form and send to Email ID.