Super Stockist Application Form

Business Information

Business established date

Capital amount

What types of products do you currently sell?

Which of our products are you interested in selling?

Why do you choose UMAMI products?

How do you plan to market our products?

How do you wish to have UMAMI assist you in promoting the UMAMI brand locally?

Date of Proposal:

Name of the Party:

Name of the Proprietor / Partner / Director Mobile No:

Address of Business (Pin code is must):

Address of Warehouse: (If Separate from office)

TNGST No. (Kindly attach certificate copy):

PAN No. (Kindly attach Certificate Copy):

Year of establishment:

Proposed Coverage Areas:

Name of Authorized Signatory:

No. of Field Personal employed:

Total No. of Parties / Retailers serviced by the firm:

Please make sure that all information provided above is correct and factual. Once the form is complete, all information listed will be kept strictly confidential between the companies applying. It shall not be released to any third party.

Company Name:

Applicant Name:

Date:

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Please send this application form through Registered Post (or) e-mail only.

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