APPLICATION FORM FOR ASSOCIATE DEALERSHIP

INSTRUCTIONS TO THE APPLICANT

1. Kindy go through the complete form thoroughly before filing it up.

2. It may be noted that ”APPLICANT” here refers to the Main Promoter/ Partner who
would run the day to day operations of the proposed Associate DeaIer
3. This application form should be filled in ENGLISH Language only, either by TYPING or
in BLOCK LETTERS with Black Ink.
4. All the financial information mentioned should be in Rs. LACS.
5. Multiple locations can be applied for; A n applicant must fill a separate application form
for each location (A blank form can be photocopied for this purpose). All such
applications should be sent within the same envelope.
6. All applications for the Associate dealership must be sent in the envelope provided.
The LOCATION (S) applied for must be clearly mentioned at the top of the envelope.
7. If the space provided for giving the information is insufficient, then take photocopy
of the relevant portions and attach as annexures clearly stating the section and sub-
section, which the information relates to.
8. CHECKLIST FOR ENCLOSURES (MOST IMPORTANT)
a) Passport size photograph of the Main Promoter. (Sestion-2).
b) Certificate of age Proof-(School Leaving Certificate/Driving License/Any other).
c) Certificate for educational qualification.

d) Certificate for any awards, honour or recognition received.

e) Please attach Banker's letters confirming credit worthiness (Solvency Certificate
from Nationalized Bank)
f) City map showing location of site (s)- (Section -8F1)
g) Detailed plan (s) showing layout of the proposed site (s) and the neighboring areas.
(Section- 8F2)
h) Property documents as of ownership/lease of proposed sites. (Section-8F3)
i) A copy of the relevant city / state by laws indicating that the proposed piece of land
can be used for setting up a dealership of 2 wheelers (Inclusive of a Showroom and a
Workshop).(Section-8F5)
j) At least two recent postcard sized photographs of the proposed site(s).(Section-8F10)
k) Copy of the Income tax returns of the Main Promoter for last three years.
I) Balance sheet and "Profit & Loss statement" for the current business of the Main
Promoter for last Three Years (Audited I C.A Certificate)
m) C.A. certificate confirming investment in the current business in land & building.
n) Family Tree (At least 3 generations)
o) C.A certified Net Worth certificate

Honda Motorcycle & Scooter India Pvt. Ltd.

 S.No.

1. LOCATION APPLIED FOR

2. PERSONAL PARTICULARS OF THE MAIN PROMOTER

(WHO WOULD RUN THE DAY TO DAY OPERATIONS)

a) Name
Please affix a
b) Date of Birth c) Marital Status
recent passport
d) Age years e) Citizenship size color

f) Address: (Please tick the preferred correspondence address

In the box indicated)

Residence:

Pin

Tel: Fax: E-mail:

Mobile :

Office:

Pin

Tel: Fax: E-mail:

g) Educational Qualifications:

Particulars Year of Institution Degree

Passing
Graduation
Post-Graduation
Any Automobile Related
Degree
Any Other Degree/Course

h) Awards/ Honours / Recognition, if any:

Description of Honour Year Nature of Achievement

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 3. BRIEF BACKGROUND (FAMILY & BUSINESS) OF THE MAIN PROMOTER

4. BUSINESS PARTICULARS OF THE MAIN PROMOTER

A) TOTAL EXPERIENCE Years

Total
Period Firm / Co’s. Name & Product/Brand % Investment Annual Turn No. of
Constitution of firm (including land Over Employees
Stake (Rs. Lacs)
& building)
Rs(Lacs)

Pvt. Ltd. Co. / Public Ltd. Co. / Partnership / Proprietorship

B) Business Investment Details

Banking Facilities (Rs. Lacs) *
(Give Full Names and Addresses) Own
Over Total
Fund L/C C/C Draft

1.

2.

A. Please attach Banker's letters confirming credit worthiness (Solvency Certificate from Nationalized Bank)

Honda Motorcycle & Scooter India Pvt. Ltd. 3

 5. BUSINESS PARTICULARS OF THE OTHER PROMOTERS / PARTNERS

A) First Promoter’s Name Date of birth

(Other than Main Promoters)

% Total Annual Turn

Firm / Co’s. Name& No. of
Period Product/Brand Investment Over
constitution of firm Stake Employees
(Rs. Lacs) (Rs. Lacs)

B) Second Promoter’s Name Date of birth

Total Annual Turn

Firm / Co’s. Name& % No. of
Period Product/Brand Investment Over
constitution of firm Stake Employees
(Rs. Lacs) (Rs. Lacs)

C) Third Promoter’s Name Date of birth

% Total Annual Turn

Firm / Co’s. Name& No. of
Period Product/Brand Investment Over
constitution of firm Stake Employees
(Rs. Lacs) (Rs. Lacs)

Pvt. Ltd. Co. / Public Ltd. Co. / Partnership / Proprietorship

Honda Motorcycle & Scooter India Pvt. Ltd. 4

 6. IF DEALING IN 2-WHEELERS

A) Name of the Co. / Brand dealing with

B) Sales Volume/ month Nos.
C) Mention Facilities Available
(I) AREA (2) ANNUAL TURNOVER lac.
a) Showroom Sq.ft. a) Sales lac
Frontage ft. b) Spares lac
- Average Stock/month lac
b) Spare Parts Sq.ft.
c) Service lac(only labour)
c) Workshop Sq.ft.
- No. of vehicles serviced/month nos
d) Warehouse Sq.ft.
- No. of Field Service Vehicles nos
- Automated w/shop Yes No
(If Yes Attach Photograph)
(3) TOTAL NO. OF STAFF nos. (4) LAND/BUILDING (please tick)
a) Sales nos. a) Showroom owned leased
b) Spares nos. b) Workshop owned leased
c) Service nos. c) Warehouse owned leased
d) Others nos. (please tick)

7. IF DEALING IN 4 WHEELERS

A) Name of the Co. / Brand dealing with

B) Total Sales Volume/Month Nos.
C) Mention Facilities Available
(I) AREA (2) ANNUAL TURNOVER lac.
a) Showroom Sq.ft. a) Sales lac
Frontage ft. b) Spares lac
b) Spare Parts Sq.ft. - Average Stock/month lac.
c) Workshop Sq.ft. c) Service lac (only labour)
d) Warehouse Sq.ft. - No. of vehicles serviced/month nos
- No. of Field Service Vehicles nos
- Automated w/shop Yes No
(If Yes Attach Photograph)

(3) TOTAL NO. OF STAFF nos. (3) LAND/BUILDING (please tick)

a) Sales nos. a) Showroom owned leased
e) Spares nos. b) Workshop owned leased
f) Service nos c) Warehouse owned leased
g) Others nos. (please tick)

Honda Motorcycle & Scooter India Pvt. Ltd. 5

 8. FACILITIES PROPOSED FOR HMSI 2-WHEELERS ASSOCIATE-DEALERHIP

A) PROPOSED NAME OF THE FIRM

B) CONSTITUTION OF PROPOSED FIRM

Pvt. Ltd. Co. / Public Ltd. Co. / Partnership / Proprietorship

C) ADDRESS OF THE PROPOSED LAND/BUILDING

D) EXPECTED ANNUAL SALES VOLUMES AND MANPOWER

Year 1 Year 2 Year 3
Volume
Sales - Sales - Sales -
Service - Service - Service -
Manpower
Parts - Parts - Parts -
Safety - Safety - Safety -

E) FINANCE
1. How much are you prepared to invest (including land & building) in this associate-
dealership? (Give Maximum Amount)
(Rs. Lacs) (Own % / Bank % )

2. Does the provision of this amount require you to liquidate some assets? YES / NO

If yes, please give details of the assets which would be liquidated and how?

3. Please specify the amount of Working Capital proposed for the associate -

dealership?

(Rs. Lacs) ( Own % / Bank % )

4. Please furnish the details of other promoters / partners in this associate - dealership?
Years of business Investment Nature of
Name of the Relationship with % of Involvement
association with Amount
stakeholder main promoter A Equity
the main promoter (lac)

A Friend / Business Partner / Relative-Please Specify

Shareholder / Director / Active or Sleeping Partner

Honda Motorcycle & Scooter India Pvt. Ltd. 6

 F) LAND/BUILDING

1. Please attach along with this form a city map showing location where you propose to set-up this
associate dealership.

2. Please attach along with this form a detailed site plan (to scale) showing the layout of the
proposed land and the neighboring area. (Also show exact dimension of the facility in meters)

3. Whether the Land / Building is: SHOWROOM

(PLEASE TICK) a) Area Sq.ft.
Owned b) Dimensions L x B ft.
Leased c) Frontage ft.
d) Parking Space Sq.ft.
If Leased, specify rent / month
PARTS
(Rs. Lacs) a) Area Sq.ft.

(Please furnish a copy of the ownership/ WORKSHOP

lease documents, In case they are in local a) Workshop Area Sq.ft.
language, kindly translate the relevant
information in English WAREHOUSE
a) Covered Area Sq.ft.

4. How long it will take to make 3S infrastructure ready from the date of LOI received _____
months
5. Do the building by laws allow you to construct/run a showroom cum workshop on this land?

(please furnish a copy of the relevant city / state by law as proof that the proposed piece of Land
can be used for setting up a 2-wheeIer associate dealerships inclusive of a showroom and a
workshop)
6. Has any of the promoter/ relatives as per family tree been into business of 2 wheelers. If yes,
give details.
___________________________________________________________
_____________________________________________________________

7. Have you applied for Honda’s Authorized Main Dealership/Associate Dealership ever before?
If yes
Location Month/Year of application
Whether interviewed by HMSI Yes No
8. Are you or any of your relative are business partners with HMSI ?
If yes, please specify
Authorized Main Dealership Associate-Dealership ASC Vendor
Stockist Transporter
Duration of association with HMSI Location

Honda Motorcycle & Scooter India Pvt. Ltd. 7

 9. What will be your unique business approach to promote Honda Brand in your area.
(more information can be attached in separate annexure).

Honda Motorcycle & Scooter India Pvt. Ltd. 8

 Kindly share your family tree (3 Generations one above and one below of the main
promoters with age, education and business/ profession).

One Generation
Above main promoter

Main Promoter

One Generation
Below main promoter

Honda Motorcycle & Scooter India Pvt. Ltd. 9

 10. Please attach two recent postcard sized photographs of the site in the boxes indicated
(More photographs can be attached as annexures)

PHOTOGRAPH - 1

PHOTOGRAPH - 2

Honda Motorcycle & Scooter India Pvt. Ltd. 10

 DECLARATION
1) The applicant certifies that he/she has made full disclosure of all the information required in
this application and all the information given by him/her is true in all respects. He / She further
acknowledges that any misinterpretation, whether intentional or unintentional, in the information
submitted in connection with the application shall be grounds upon which Honda Motorcycle & Scooter
India (Pvt.) Ltd. (HMSI) may either: (a) Decide to no longer consider his/her application OR (b)
Immediately terminate any associate-dealership agreement executed by HMSI with him/her or the
dealer company designated by him/her.

2) This applicant acknowledges that this is only an application for associate-dealership and by
submitting this application; he/she will not place any obligations on HMSI to appoint the applicant as
an associate-dealer of HMSI.

3) The applicant certifies that he/she is not suffering from, or aware of any legal disability that
would prevent him/her from being appointed as an Associate Dealer of HMSI.

4) The applicant acknowledges that any obligations undertaken or expense incurred by him/her
in submitting this application shall be incurred entirely on the applicant’s own behalf.

5) The applicant hereby authorizes HMSI to make any inquiries it may consider necessary to verify
this information and will not consider such inquiry to constitute an invasion of his/her privacy.

6) The applicant acknowledges that copies of all documents, photographs etc. furnished by him/her
to HMSI in the process of applying for associate dealership would henceforth become a property
of HMSI and may be retained by them for their records.

7) The applicant hereby authorizes the receipt, provision, verification, and exchange of relevant credit
related information from / with any source including banks, credit rating agencies, credit bureaus in
respect of his/her personal account as well as business for the purpose of considering his/her
request.
8) The applicant certifies that he/she never been convicted by court in India for any criminal offence,
hence sentenced to imprisonment preceding the date of application.

DATE:

NAME OF THE APPLICANT: SIGNATURE:

NAME OF THE WITNESS: SIGNATURE:

NOTE: The submission of your Associate Dealer Application Form is only the first step in the
process to qualify for HMSI Associate Dealership. Until you are officially informed in writing
and are presented with an Associate Dealership Letter of Intent, you are not appointed as
HMSI associate dealer. Only after completion of Terms & Conditions in the LOI and after
due diligence by HMSI nominated Team, we enter into an Associate Dealer agreement for
official commencement of Honda Associate Dealership Operations. Until then, you should
not rely on any action or communication from HMSI to the contrary.

Honda Motorcycle & Scooter India Pvt. Ltd. 11

 REFERENCES

REFERENCES 1 REFERENCES 2 REFERENCES 3

NAME

CONTACT NO.

EMAIL ID

PROFESSION

RELATIONSHIP
WITH
APPLICANT

KNOWN SINCE
(NO. OF YEARS)