Distributor Application

Rasa Curry Masala

Distributor Application Form

1. Personal / Applicant Details

Full Name *

Father / Spouse Name *

Date of Birth (DOB) *

Mobile Number *

Email Address *

2. Business Details

Firm / Company Name *

Type of Business *

Proprietorship Partnership Private Limited Other

Registered Office Address *

PIN Code *

Godown / Warehouse Address

3. Legal & Tax Details

GSTIN Number

PAN Card Number *

Trade License / Udyam Registration No.

4. Financial & Banking Details

Bank Name

Account Number

IFSC Code

Branch Name

5. Distribution Experience & Infrastructure

Currently working with any Brand/Company?

Total Business Experience (Years)

Proposed Territory / District *

6. Required Documents Checklist

✅ PAN Card Copy
✅ GST Registration Certificate
✅ Address Proof (Aadhaar / Rent Agreement / Electricity Bill)
✅ Cancelled Cheque / Bank Statement

* Note: Please send digital copies or photos of these documents via WhatsApp chat after submitting this form.

Declaration:
I hereby declare that all the information provided in this form is true and accurate to the best of my knowledge. If any information is found to be false or incorrect, the company reserves the right to reject my application.

I agree to the terms and declaration above. *