VENDOR CREATION/MODIFICATION FORM
* Fields marked with * and bold red are mandatory fields.
(To be filled in BLOCK letters)
1
Status*(tick one)
2
Vendor name*
Individual
Sole Proprietor
Partnership
Company
LLP
Others:
(First name)
(Middle name)
(Last name)
3
Contact person 1*
Contact person 2
Mobile-1*
+
9
1
Mobile-2
+
9
1
5
Landline
S
T
D
6
Email ID 1*
4
co de
Email ID 2
7
ID Proof type*
PAN card
Voter ID card
Passport
Driving Licence
Aadhar Card
Others
Aadhar Card
Voter ID card
Passport
GST Certificate
Others
8
ID Proof number of ID card ticked above*
9
Address Proof type*
Incorporation Certificate
GST Certificate
If Others, please specify:*
Driving Licence
Incorporation Certificate
If Others, please specify:*
10 Address Proof number of Address ID card ticked above*
11 Address*
(for communication)
H
O
U
S
E
S
T
R
E
E
N
T
O
N
A
M
E
Landmark
City
POSTAL CODE
State
COUNTRY
12 PAN*
13 GST registration type*
PAN in the name of the vendor?:
Unregistered
Registered
Composite dealer
14 GSTIN*
15 Whether covered under MSME provisions?*
Yes
No
16 MSME Registration No.*
17 MSME - Industry type*
Micro
Small
Medium
18 AADHAR number
19 Relationship with the company:*
Customer
Vendor
Both
20 Is there an existing business relationship with the company? If yes, please provide details below (Name/details of related party):
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Yes
No
21
Bank Account details*
Name as per the
bank account
Name same as in point. 2?
Yes
No
Name (if answer is
no above)
Name of the bank
Account number
IFSC/SWIFT code
Branch name
Account type
22
Whether import vendor?*
Savings Account
Yes
Current Account
No
Others, please mention here -
If Yes, IEC as per certificate*
Country of citizenship, incorporation, or formation:
[Note: Mandatory fields (12) to (17) not applicable for import vendors]
I/We hereby confirm and certify that the information and attachments given herein true and accurate, any subsequent changes would be duly communicated to
IB group by submission of a fresh form along with relevant supportings.
Signature of the Vendor/Supplier
FOR OFFICE USE ONLY
To be filled by respective teams at IB dealing with the vendor
IB SPOC 1
Name:
E-mail ID:
IB legal entity name:*
Payment Terms:*
Mobile Number:
IB SPOC 2
Related vendor code (if any):
Name:
E-mail ID:
Related customer code (if any):
Mobile Number:
Exception w.r.t. any details required in form:*
If Yes, Exception's remarks:*
Yes
No
Form reviewed by:*
Reviewer's signature:*
To be filled by Master Data Management Team at IB
Vendor code*:
Account group:*
Form reviewed by:*
Approval from Master data Manager for exception (if any):
Reviewer's signature:
Date of review
Date of approval:
Guidelines for supporting documents/details to be provided by vendors
Field name
Reference
6
Email ID
Supportings for validation
Test e‐mail from vendor.
[PAN Card,Voter ID Card, Passport, Driving License, Aadhaar card, Incorporation certificate of entity, GST Certificate, any other valid ID
7&8
ID Proof Type
proof recognized by GOI]
[Voter ID Card, Passport, Driving License, NREGA Job Card & Others, Letter issued by National Population Register containing details of
9, 10 & 11 Address ID Type
name, Aadhaar card, Incorporation certificate of entity, GST Certificate, any other valid address proof recognized by GOI]
PAN Card
12
PAN
GST Certificate/Recently filed returns
13 & 14
GSTIN
15, 16 & 17 Whether MSME
MSME certificate
20
Bank account details A cancelled cheque.
Import vendor
IEC certificate, Incorporation Certificate, any othervalid ID and address proof providing sufficient evidence of details furnished
22
details
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