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Vendor Registration Form

The document is a Vendor Registration Form for Academian India Private Limited, requiring details such as vendor name, organization type, contact information, tax details, and bank information. It includes sections for new registrations and changes to existing vendors, with mandatory fields marked. A declaration is required from the authorized signatory to confirm the accuracy of the information provided.

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NUPURNIGAM
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28 views

Vendor Registration Form

The document is a Vendor Registration Form for Academian India Private Limited, requiring details such as vendor name, organization type, contact information, tax details, and bank information. It includes sections for new registrations and changes to existing vendors, with mandatory fields marked. A declaration is required from the authorized signatory to confirm the accuracy of the information provided.

Uploaded by

NUPURNIGAM
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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Academian India Private Limited

Office no.02, 3RD FLOOR, CEREBRUM B-03 IT PARK, Survey No.: 13B/1+2+3, 14 (P), Kalyani Nagar,
Vadgaon Sheri, Pune, 411014, Maharashtra

VENDOR REGISTRATION FORM

NEW REGISTRATION CHANGES in EXISTING VENDOR

SECTION I : VENDOR's NAME / ADDRESS / CONTACT DETAILS

1 Vendor's Name* :

: Company Individual
2 Type of Organisation*
Partnership Others Please Specify __________

[If Company, mention CIN of the Company]*

3 Are you a Micro, Small or Medium Enterprise* : YES / NO : [ If yes, please attach certificate]

4 Does your organisation have any personnel related / connected to


:
our personnel resulting in any conflict of interest*
5 Nature of Service*

Mailing / Business Address [ including Pincode ]*


6 (If registered under GST, the address should either be principal or :
additional place of business as per GST Certificate)

7 Contact Person Name* :

8 Designation :

9 Contact No.* :

10 Email Address* :
1

SECTION II : TAX DETAILS

1 Permanent Account Number ( PAN )


:
[ Attach copy of PAN Card ]*

GST Number (If not registered mention "Unregistered")


2 :
[Attach copy of GST Certificate, if registered]*

MSME Number (If not registered mention "Unregistered")


3 :
[Attach copy of MSME Certificate, if registered]*

SECTION III : BANK DETAILS

1 Account Name* :

2 Account Number* :

3 Account Type* : Current Savings Others _____________

4 Name of the Bank* :

Branch name and address [including Pincode]


5 :
(Attach copy of Cancelled Cheque)*
NEFT IFSC Code (for Domestic Remittance) or SWIFT Code / ABA
6 :
Code / SORT Code / IBAN (for Foreign Remittance)*

DECLARATION
I / We certify that the information furnished above is correct and complete to the best of my / our knowledge and belief and the organisation's Code of Conduct will
be complied with whilst delivering goods and services.

Authorised Signatory Date Name & Designation


( Authorised signatory of vendor with the organisation stamp )

Note 1: Items marked with (*) are mandatory to fill. Please do not delete any blank column, mention "Not Applicable" instead.
Note 2: In case there is a change in above information, please inform accordingly in separate vendor form.

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