Shahlon Group

Customers Registration Form

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Name of Firm / Company * :
Nature of Business :
Product Category :
Name of Proprietor / Partner / Director :
   
Contact Person * :
Address * :
Country :
State :
City :
Zip :
Phone No. * :
Fax No. :
Mobile No. :
Email :
Website :
   
Contact Person :
Address :
Country :
State :
City :
Zip :
Phone No. :
Fax No. :
Mobile No. :
Email :
Website :
GST / VAT No. & Date :
CST No. & Date :
PAN No. :
IEC No. & Date :
     
Excise Reg. No. & Date  
Commissionrate :
Range :
Division :
     
Ref. By :
Message :