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Doing Business Distribution with Us Domestic

(* represents compulsory fields )

*Name of the Firm

Constitution: Proprietorship
Partnership / Limited Company

*Place of Registration

*Address

*Telephone Nos

*Email Id:

Name(s) of the Proprietor / Partners /
Directors - with residential
Addresses telephone /
mobile numbers & email IDs

Bankers (with address of the Branch):

Sales Tax Registration Details :

*Brief description of current businesses
under this enterprise :

Are you currently exposed to the CFL business: Yes / No If 'yes' - then please give details of Brands dealt with and the value of the business

Godown / Stocking Point Address

Billing Address

Area sought for ECO-GLO Distribution

Potential in terms of value of business relevant to our range of products

Investment set aside for ECO-GLO Distribution

Now Six months laterA year Later

Number of Dealers / Retailers currently being dealt with

Number of Dealers / Retailers that you will engage in ECO-GLO business

Number of people currently deployed in Market activity in your set up

Number of people that you plan to depute for ECO-GLO Business

Your reasons for seeking the distributorship of ECO-GLO

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