Vendor Registration Form

(For Empanelment of Vendors / Suppliers / Service Providers)

Name of Organisation:

Type of Organisation:

Year of Establishment:

Registered Office Address:

Communication / Corporate Office Address:

Mobile Number: E-Mail:

Name: Designation: Phone (Office):
Phone (Residence):

Mobile: Email:

Website:

Nature of Business:
Products / Services Offered: Major Customers (Top 5): Major Projects Executed (if applicable):

Number of Employees:

Parent Company / Group (if any):

PAN No: TAN No: GST Vendor Type: GST Registration No:

CIN (Company Identification No.): SSI / MSME / Udyam Registration No.:

ESI No.: PF No.: Labour Licence No. (if applicable):

Professional Tax No.: Shops & Establishment Regn. No.:

Other Licenses (if any):

Bank Name:

Bank Account No.:

Branch Name & Address:

MICR Code:

IFSC Code:

SWIFT Code (for international vendors):

(Attach cancelled cheque copy / bank verification letter)

ISO / Quality Certifications:

HSE Policy (attach copy): Yes No

CSR / Sustainability Compliance: Yes No

Past Blacklisting by Govt. / PSU / Corporate (if any): Yes No

Business References (at least 2):

Reference 1:

Reference 2:

(Attach supporting documents such as certificates, company profile, etc.)