Simond Fibertech


APPLICATION FORM FOR DEALERS

Name of the Firm	:

Address	:

Contact Person	:

Phone No.	:

Mobile No.	:

GST TIN NO.	:

CST TIN NO.	:

ECC NO. (if any)	:

Year of Establishment	:

Sales for Financial Year 2007-2008	:	Rs.

Sales for Financial Year 2008-2009	:	Rs.

Are you selling Highlighters? (Yes / No) If yes, then the sales of the highlighter for the year 2008-2009 Rs.	:

No. of customers with whom you are dealing regularly	:

Name of the States and Metropolitan city in which you are selling tiles	:

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