Manufacturer or Wholesaler Registration Form

* Name

* Company Name

* Position in Company

* Phone

* Email Address

* State

* City

* Address

* Zip Code

* Business Type

* Year of Establishment

* Registered Office Address

* Type of Manufacturer

* List of Equipment Manufactured

* Brand Name(s)

* Company PAN Number

* GSTIN

MSME Registration Number

* Company Documents

Self Declaration

I hereby declare that all the information and details provided by me in this registration form are true, complete, and correct to the best of my knowledge and belief. I have not concealed or misrepresented any facts.

I confirm that I am a legitimate manufacturer/wholesaler and possess all necessary licenses and approvals required to operate under this business category. I have not availed any subsidy or benefits under this scheme previously.

I understand that if any information is found to be false or misleading, my registration and any benefits derived from this application will be cancelled or revoked without notice. I also agree to submit the refundable application fee upon registration and the remaining security amount in advance.