| DIRECTORATE OF MUSHROOM RESEARCH(Indian Council of Agricultural Research)Chambaghat, Solan-173213 (Himachal Pardesh)Tel No.01792-230177, 230767,230541 & Fax No.01792-231207 |
| Application form for registration of firms for indigenous /imported stores asManufacturers/Assemblers/Contractors/Suppliers |
1. Category under which registration is sought (tick as appropriate: a) Manufacturer
b) Assembler
c) Contractor
d) Supplier
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2. Name of Applicant firm:
Address/telephone/fax/e-mail/Website
a) Regd. Office:
b) Head Office:
c) Other Offices:
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3. Status of applicant firm
a) Date of Incorporation:
b) Proprietorship/ Public Limited/Private Limited Industrial
Cooperative
c) Sales Tax registration no.(s)/TIN No.
d) PAN No.
e) If firm is Contractor of Labour/Security etc. then firm
must mention its Registration No.
f) Past Experience
g) On Line Bank Account No.
h) Product catalogue alongwith Price list to be attached
i) If firm is authorized dealer of manufacturers (copy of current authorization certificate
of manufacturers in favour of firm to be attached)
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4. Stores for which registration is required
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Brief Description |
Ref. Of ISI/ISOSpecification |
Mode/Brand |
Limited size/capacity/Rating |
Annual production Capacity per shift |
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5.
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Whether registered with DGS&D and/or NSIC or any other Government organization? If so, furnish copies of such registration letters. |
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6.
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Annual turnover for last three years (year wise) |
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7.
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Name and address of the Bankers(Indicate Account No. with each Bank) |
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8.
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Name and Designation of the signatory of this Application (enclose a copy of power of attorney where applicable) |
sd/
Signature of Authorized signatory(ies)With Seal |
