User Type : Existing New
1. Name of Individual, Firm, Company, Association or Corporate (Paid up capital of above Rs. 50 Crore)
2. Address: Office: Factory: 3. Category: Subscribed/Life/Patron Membership:
(1. Individual, 2.HUF, 3.Proprietorship Firm, 4. Partnership Firm, 5.Company, 6. Association, 7. Corporate)
Year of Establishment
Name of Business 4. Contact Numbers: Email id: 5. Name and contact details of the two other representative(Not for individual membership) i order of priority:
I. Name: Status or Relation in the Firm/Company: Mobile No: Email:
ii. Name: Status or Relation in the Firm/Company Mobile No.: Email:
6. Additional Information of the Unit:
I. Whether a small, medium or large industry:
ii. MSME Registration No.:
iii. GST No. of Firm/Company:
Vi. Any other Registration with Govt. Dept.:
7. If member of any chamber or association, give details: