Customer Registration Form
Note : Please fill in all required information
1. Organization Name
*
2. Company GST
*
3. PAN Number
*
Billing Address
Address Line 1
*
Address Line 2
City
*
State
*
Select state
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Goa
Gujarat
Haryana
Himachal Pradesh
Jharkhand
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
Andaman and Nicobar Islands
Chandigarh
Dadra and Nagar Haveli and Daman and Diu
Delhi
Jammu and Kashmir
Ladakh
Lakshadweep
Puducherry
Pincode
*
Delivery address same as billing address
Delivery Address
Delivery Addresses
*
+ Add Delivery Address
Address Line 1
*
Primary
Set
Address Line 2
City
*
State
*
Select state
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Goa
Gujarat
Haryana
Himachal Pradesh
Jharkhand
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
Andaman and Nicobar Islands
Chandigarh
Dadra and Nagar Haveli and Daman and Diu
Delhi
Jammu and Kashmir
Ladakh
Lakshadweep
Puducherry
Pincode
*
Contact Information
Accountant
*
+ Add Another
Accountant Name
Accountant Contact
Accountant Email
Sales Person
*
+ Add Another
Sales Person Name
Sales Person Contact
Sales Person Email
Office Number
*
Proprietor / Owner Contact Number
Reference Details
Person Name
Person Contact
Person Email
Business Details
Manufacturer / Moulding / Processing
Raw Material Manufacturer
Compounder
Trading / Distribution
Masterbatch Manufacturer
Monthly Material Consumption Volume
*
ABS
Consumption (MT/month) for ABS
Preferred Grade for ABS
PC
Consumption (MT/month) for PC
Preferred Grade for PC
PMMA
Consumption (MT/month) for PMMA
Preferred Grade for PMMA
SMMA
Consumption (MT/month) for SMMA
Preferred Grade for SMMA
GPPS
Consumption (MT/month) for GPPS
Preferred Grade for GPPS
HIPS
Consumption (MT/month) for HIPS
Preferred Grade for HIPS
POM
Consumption (MT/month) for POM
Preferred Grade for POM
K-RESIN
Consumption (MT/month) for K-RESIN
Preferred Grade for K-RESIN
LDPE
Consumption (MT/month) for LDPE
Preferred Grade for LDPE
HDPE
Consumption (MT/month) for HDPE
Preferred Grade for HDPE
UHMWPE
Consumption (MT/month) for UHMWPE
Preferred Grade for UHMWPE
PVC
Consumption (MT/month) for PVC
Preferred Grade for PVC
PP
Consumption (MT/month) for PP
Preferred Grade for PP
SAN
Consumption (MT/month) for SAN
Preferred Grade for SAN
Wood Plastic
Consumption (MT/month) for Wood Plastic
Preferred Grade for Wood Plastic
Acrylic Sheet
Consumption (MT/month) for Acrylic Sheet
Preferred Grade for Acrylic Sheet
PET
Consumption (MT/month) for PET
Preferred Grade for PET
Other
Consumption (MT/month) for Other
Preferred Grade for Other
Material Name
*
Consumption (MT/month)
*
Preferred Grade
Primary Industries Served by you
*
Automotive
Home Appliances
Textile
Kitchen / Tableware
Cosmetics
Toys
Lighting
Jewellery
Medical
Sanitary Hardware
Construction / Building Materials
Packaging
Engineering
Sheet / Rods / Profiles
Furniture
Other
If Other, please specify
Payment terms
*
If any group/sister company, please mention company name
Upload GST Certificate (Image or PDF)
*
Click to upload (Max 2MB)
Upload PAN (Image or PDF)
*
Click to upload (Max 2MB)
TAN Certificate (Image or PDF)
Click to upload (Max 2MB)
MSME Certificate (Image or PDF)
Click to upload (Max 2MB)
Submit Application
