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
Purchase Person
*
+ Add Another
Purchase Person Name
Purchase Person Contact
Purchase 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
Acrylic Sheet
Consumption (MT/month) for Acrylic Sheet
Preferred Grade for Acrylic Sheet
EVA
Consumption (MT/month) for EVA
Preferred Grade for EVA
EPS
Consumption (MT/month) for EPS
Preferred Grade for EPS
GPPS
Consumption (MT/month) for GPPS
Preferred Grade for GPPS
HDPE
Consumption (MT/month) for HDPE
Preferred Grade for HDPE
HIPS
Consumption (MT/month) for HIPS
Preferred Grade for HIPS
K-RESIN
Consumption (MT/month) for K-RESIN
Preferred Grade for K-RESIN
LDPE
Consumption (MT/month) for LDPE
Preferred Grade for LDPE
LLDPE
Consumption (MT/month) for LLDPE
Preferred Grade for LLDPE
Nylon 6
Consumption (MT/month) for Nylon 6
Preferred Grade for Nylon 6
Nylon 66
Consumption (MT/month) for Nylon 66
Preferred Grade for Nylon 66
PBT
Consumption (MT/month) for PBT
Preferred Grade for PBT
PC
Consumption (MT/month) for PC
Preferred Grade for PC
PET
Consumption (MT/month) for PET
Preferred Grade for PET
PMMA
Consumption (MT/month) for PMMA
Preferred Grade for PMMA
POM
Consumption (MT/month) for POM
Preferred Grade for POM
PP
Consumption (MT/month) for PP
Preferred Grade for PP
PU
Consumption (MT/month) for PU
Preferred Grade for PU
PVC
Consumption (MT/month) for PVC
Preferred Grade for PVC
SAN
Consumption (MT/month) for SAN
Preferred Grade for SAN
TPU
Consumption (MT/month) for TPU
Preferred Grade for TPU
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
