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Supplier Registration Request Form
Title
Company
Proprietor
HUF
Partnership Firm
Society
Trust
Others
Supplier Full Trade Name (As per GST Registration)
*
Vendor Category
Material Supplier
Service Provider
Communication Details
Name of Authorized Person
*
Mobile No. of Authorized Person
*
Email ID of Authorized Person
*
Mobile No. of Supplier Contact Person
Email ID of Supplier Contact Person
Other Mobile No
Other Email ID
Designation of Contact Person
*
Name of the (HGEIL) Buyer
*
Mobile No. of the (HGEIL) Buyer
*
Address Details
Street Address
*
Apartment, suite, etc
City
*
State/Province
*
ZIP / Postal Code
*
Other Details
Category
*
Region
*
Department
*
Statutory Compliances and Tax Details
PAN Status
Available
Not Available
PAN No.
*
PAN Holder Name
*
Aadhaar Card No
TAN Status
Available
Not Available
TAN No.
*
TAN Holder Name
*
MSME Registration Status
Registered
Not Registered
Enter MSME No.
*
GST Registration Status
Registered
Not Registered
GST Status
State
*
PF Status
Yes
No
PF No.
*
ESI Status
Yes
No
ESI
*
Financial Details & Bank Details
Account Type
Current Account
Bank Name
*
Bank Branch
Bank Street
Bank City
Bank Account Number
*
Bank Key (IFSC Code)
*
Account Holder Name
*
Additional Details
Do You want to fill Additional Details
Yes
No
How many years of experience do you have in this business?
Name of Company
*
Work done Amount (Turnover)
*
Buyer Name
Buyer Contact No.
Duration of work
References
Achievements and Recognition
Latest Financial Statements Like Balance Sheet P And L Or Latest Income Tax Return
References
Plant Operation
Field Group
Count
Hired
Purchased
Capacity
Year of Purchase
Laying Equipment
Field Group
Count
Hired
Purchased
Capacity
Year of Purchase
Misc. categories equipment (Hydra, Trailer, Tanker, JCB, Crane etc.)
Field Group
Count
Hired
Purchased
Capacity
Year of Purchase
Excavation /Earthwork-Excavator related work
Field Group
Count
Hired
Purchased
Capacity
Year of Purchase
Crusher
Field Group
Count
Hired
Purchased
Capacity
Year of Purchase
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