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* compulsory fields   
Full Name of the Company:*   Contact Person's Name:*  
Tel. No.:*   Fax:
E-mail:*      
Office Add:*  
Factory Add:
Products/Items dealt with:
Actual Capacity of the Product Quoted:*  
Type of Organisation: Whether:
Annual Turnover for last 4 preceding years (or whichever applicable):

I

II

III IV
Name of three Major Customers:*    
Banker's Name :*  
Sales Tax Registration: Excise Reg.:*  
Income Tax Reg. No.:*  
Any Additional information.:

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