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B2B Application Form

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Vignesh Vinayagam
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207 views1 page

B2B Application Form

Uploaded by

Vignesh Vinayagam
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Page - I

Membership
Gold :
MSME GLOBAL MART
For official use
An exclusive B2B Web Portal for MSMEs Products
Membership : New 
Membership Application Form : Renewal 
Enter GST Number of Applicant : Activation Date:
1. Name of Company* (Write in Block Letters)
M/s

2. Name of CEO/MD Aadhaar No :


Mr. / Ms. / Mrs.

3. Address*

STATE PIN
E-mail*
Website: www. Tel. No
Mobile No 0 Fax. No.
4. Whether MSME:(Pl.Tick)  Yes  No
Udyog Aadhaar No:
5. Activities: (Pl.tick)  Manufacturer  Reseller  Service Provider

5. Category: (Pl.tick)  General  SC  ST  OBC  WOMEN

6. Product(s)* (Pl. add extra sheet if required)


1. 5. 9.
2. 6. 10.
3. 7. 11.
4. 8. 12.

7. Year of Establishment: Employment: Turnover in Rs.

8. Certification (if any)  ISO  QS  BIS  Hallmark  Other _

9. Are you an Exporter (Pl.tick) If Yes, Countries exported to:


 Yes  No

10. Give brief background and details of your company (Attach separate sheet if necessary):

11. Attach up to five images of your products

12. DD/Cheque Details: (a) Name of Bank


(b) DD./Chq./ NEFT / IMPS No.
(c) Amount: (d) Dated: (e) Date of Application:

We accept all major Credit/Debit cards / Wallets and Net Banking


13. Signature with Company’s Seal &
Date of Application

Instructions:- (Paste/staple your Photo


and business card in this
1. Gold members shall fill up the form for B2B services space)
2. Annual subscription Rs. 6,000/- + 18% GST

(Please fill the form and send it to):


The National Small Industries Corporation Ltd.
NSIC Bhawan, Okhla Industrial Estate, New Delhi-110020
Ph: 91-11-26926275, 26927502
Website: http://www.msmemart.com, E-mail: [email protected]

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