VENDOR REGISTRATION FORM
( By Finance Department Mar Sleeva Medicity )
Vendor Details (To be filled up by vendor)
General Information
Name of the entity
KIDS KOUCH
Name of the entity (Cheque will be drawn in KIDS KOUCH
this name)
Shop No.6 & 7, 1st Floor, No.35/1B, Varthur Main Road, Munnekolala,
Bangalore 560037, KARNATKA
Address
Contact person name, telephone number &
residence address of contact person
Mr. Ramnik Patel
+91 9741540007
Telephone /Mob Number
+91 9741540007
E-mail & Website
hello@kidskouch.com
Locations present
One, Same as Above
Name , Contact number & e-mail ID of the
Accountant ( who deals with ledger of
Mar Sleeva Medicity )
kidskouch@yahoo.com
www.kidskouch.com
Ramnik Patel
+91 9980944915
Nature of Business
Manufacturer
Contractor
Nature
(Tick and enclose relevant document to
substantiate the same)
Distributor
Authorized Dealer
Authorized Stockist
Authorised Wholesaler
Retailer
And Importer
Type of Firm
Type
Tick
Name of document annexed to
substantiate
Sole Proprietor
Partnership
Yes
Private Limited
Trust
Others (Name It)
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FORM GST REG-06
Registration Details
Type
Number
Tick if copy annexed
TIN
GST
29AAJFK6193M1ZI
YES
PAN
AAJFK6193M
YES
Bank Details /Bank Confirmation
HDFC
Bank Name
KIDS KOUCH
Account Name
17552020000614
Account No
BENGALURU INDIRA NAGAR 100FEET ROAD
Branch / City
HDFC0001755
IFSC Code
YES
Tick, if
annexed
Enclose Bank Confirmation (cancelled
cheque leaf or front page of Bank passbook)
CHECKLIST OF ENCLOSURES:
Particular
1.GST
YES
2. Nature of business
3. Type of firm
Particular
Tick
YES
Tick
4. TIN
5.PAN
YES
6.Bank confirmation
YES
Authorized Signature of Vendor
Company Seal
Place:
Date
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