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Distributor application form

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Comapny name:

Address:

Phone no.:

Mobile no.:

Fax:

E-mail: *

Name of the Proprietor/ Partner/ Director/ Manager and Position

Particulars of Business background:

Status of Firm/ origin:

Establish in:

Branches:

Location of H.O :

Strength of employees Sales:

Strength of employees Service:

Tin No & Date :

Profile :

Pan Card No. & Date:

Bank Name :

Account:

Bank address:

Sale Point:

Service Point:

Total Initial Investment : Rs.

Space Front (10 Ft Min.) Showroom :

Space Total (220 Sq.Ft min.) :

Existing/ Running business:

To,

Mova Systems Private Limited, Ludhiana

Dear Sir, Madam

I/ we hereby declare that all the above mention details furnished are true & correct and agree with all of your promoted product range for marketing. In case any of the information is found misleading or misrepresenting I am aware that I may held liable for it.

Yours Faithfully

Place: