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1 New Dealer Appointment Form

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Date: 01-05-2023

NEW DEALER APPOINTMENT FORM

To be filled by the applicant and submitted to the CSO


S.
No. PARTICULARS
1 Date of Proposal:
2 Name of the Party :
3 Nature of Business :
(Proprietorship/Partnership/ Company)
4 Name of the Proprietor / Mobile No.:
Address of Business (Pin code is must) :
Computer:
Internet:
Availability of :
Code:
Phone No.
Email:
Contact Nos.:
Address of warehouse :
(If Separate from office)
Whether office or Warehouse is
leased/owned?
(If leased, Please submit rent deed copy)
Mention the details of infrastructure in
Warehouse along with Temperature
control mechanism in storage area:
Whether related to any one in Neictar
Asia?
VAT/CST NO. : (Kindly attach certificate
copy)
DL NO. 20B & 21B:(Kindly attach
certificate copy)
PAN NO. :(Kindly attach certificate copy)
Year of establishment :
Proposed Coverage area :
Address of Branches / Sister concerns (If
any)
Capital employed (in Lacs)
Annual Turnover (In Lacs)
Name of Banker with Address :
Document No. NEA-000-0-000-00-0 Page 1 of 2
Date: 01-05-2023
NEW DEALER APPOINTMENT FORM

Bank A/C No. :


Name of Authorized Signatory
Details of Persons / Employee who will
be assigned for Neictar Asia transactions:
No. of Field Personnel employed :
Total No. of Parties/Retailers serviced by
the firm :
Distribution Facilities:

TERMS & CONDITIONS :

 PAYMENT TERMS 100 % ADVANCE UNLESS SPECIFIED IN WRITING.

 WE DO NOT AUTHORIZE CASH/GOODS TRANSACTIONS WITH OUR FIELD PERSONNEL & YOU WILL BE
SOLELY RESPONSIBLE FOR SUCH TRANSACTIONS AND LIABILITIES ARISING OUT OF THESE.
 STORAGE CONDITIONS SHOULD BE IN COMPLIANCE WITH THE STATUTORY
REQUIREMENTS AS WELL AS THE NATURE OF GOODS.
 SHORT EXPIRY HAS TO BE INFORMED AT LEAST SIX MONTHS IN ADVANCE.

 GOODS RETURN AGAINST EXPIRIES HAVE TO COMPLY WITH PREVAILING NORMS.

 THE COMPANY IS AUTHORIZED TO APPOINT NEW/ADDITIONAL


DISTRIBUTORS/DEALERS/STOCKISTS AS PER THE NEED OF THE BUSINESS.

I/WE AGREE TO THE ABOVE & PROMISE TO COMPLY WITH ALL THE ABOVE MENTIONED
TERMS.

AUTHORIZED SIGNATORY
(WITH THE SEAL OF THE FIRM)

Document No. NEA-000-0-000-00-0 Page 2 of 2

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