DETAILS OF THE ORGANIZATION

Name of the Organisation

Full Postal Address of Shop/ Office

Telephone Number

STD Code

Email

TYPE OF ORGANIZATION (PROPRIETORSHIP/PARTNERSHIP/LTD. CO.)

Choose type of organization
—Please choose an option—ProprietorshipPartnershipLtd. Co.

—Please choose an option—Partnership DeedMemorandum & Articles of AssociationTrade Licence

NAME & ADDRESS OF PROPRIETOR / PARTNERS / DIRECTORS

Type
—Please choose an option—ProprietorPartnersDirectors

Name

Residential Address

Marital Status
SingleMarried

Telephone Number

STD Code

Date Of Birth

Please upload Passport Size Photograph

PRESENT BUSINESS

Name of the Co.(s) presently dealing with

Whether Distributor/ Dealer/ Sub-Dealer

Annual Turnover of the year just ended

PAST EXPERIENCE IN GENEX

• Year
  

• Brand/ QTY.(M.T.)
  

• Brand/ QTY.(M.T.)
  

• Brand/ QTY.(M.T.)
  

• Brand/ QTY.(M.T.)
  

• Brand/ QTY.(M.T.)
  

• TOTAL QTY.(M.T.)
  

PERCENTAGE OF YOUR MONTHLY SALES THROUGH WHOLESALE/ RETAIL

Wholesale %

Retail %

TRANSPORT/ LOGISTICS

Warehouse from which supplies are required

Nearest District Headquarter with distance in KM(s)

Approx. distance from warehouse to your godown

Approx. distance from plant to your godown

Name of your Authorized Transporter

STORAGE FACILITIES

Total Capacity of existing godown
space (In M.T. & Sq. m.)

Storing Capacity to be made available for storing
AAC Block

MARKET INFORMATION

Market Potential of your Locality

Brand-wise / Dealer-wise details

• Sl. No
  

• Name of the Dealer
  

• Location
  

• Tonnage
  

• Brand(s)(Write name in descending order of lifting)
  

DETAILS OF YOUR BANKERS

Name of your Bank & Branch

Address & Phone No.

Account No.

Account Type

KYC DOCUMENTS

Choose from the drop down list
—Please choose an option—Pan CardAadhar CardVoter CardDriving LicenseRation CardPassport

Upload Document

Choose from the drop down list
—Please choose an option—Pan CardAadhar CardVoter CardDriving LicenseRation CardPassport

Upload Document

DETAILS ABOUT YOUR FAMILY