Honda Application Form Page 2 To 11

Honda Motorcycle & Scooter India Pvt. Ltd.
S.No.

1. LOCATION APPLIED FOR

2. PERSONAL PARTICULARS OF THE MAIN PROMOTER (WHO WOULD RUN THE
DAY TO DAY OPERATIONS)

a) Name

b) Date of Birth c) Marital Status

d) Age e) Citizenship
f) Address: (Please tick the preferred correspondence address
in the box indicated)

Residence:
Pin:
Tel: Fax: E-mail:
Mobile:

Office:

g) Educational Qualification:

Particulars
Year of
Passing

Institution

Degree
Graduation
Post Graduation
Any Automobile Related Degree
Any Other Degree/Course

f) Awards/Honours / Recognition, if any:

Particulars
Year of
Passing

Institution

Degree
Graduation
Post Graduation
Any Automobile Related Degree
Any Other Degree/Course

2

3. BRIEF BACKGROUND (FAMILY & BUSINESS) OF THE MAIN PROMOTER

4. BUSINESS PARTICULARS OF THE MAIN PROMOTER

A) Total experience years

Period

Firm / Cos Name &
Constitution of firm

Product/Brand

%
Stake
Total investment
(including land &
building)
(Rs.Lacs)

Annual Turn
Over
(Rs.Lacs)

No. of
Employees

Pvt. Ltd. Co. / Public Ltd. Co. / Partnership / Proprietorship

B) Business Investment Details

(Give Full Names and Addresses)

Own
Fund
Banking Facilities (Rs. Lacs)
Total
L/C

C/C
Over
Draft

1

2

Please attach Bankers letters conforming credit worthiness (Solvency Certificate from Nationalized Bank)

3

5. BUSINESS PARTICULARS OF THE OTHER PROMOTERS / PARTNERS

A) First Promoters Name Date of birth
(Other than Main Promoters)

Period

Firm / Cos Name &

Product/Brand

%
Stake
Total investment
(including land &
building)
(Rs.Lacs)

Annual Turn
Over
(Rs.Lacs)

No. of
Employees

B) Second Promoters Name Date of birth

Period

Firm / Cos Name &

Product/Brand

%
Stake
Total investment
(including land &
building)
(Rs.Lacs)

Annual Turn
Over
(Rs.Lacs)

No. of
Employees

C) Second Promoters Name Date of birth

Period

Firm / Cos Name &

Product/Brand

%
Stake
Total investment
(including land &
building)
(Rs.Lacs)

Annual Turn
Over
(Rs.Lacs)

No. of
Employees


4

6. IF DEALING IN 2 - WHEELERS

A) Name of the Co. / Brand dealing with
B) Sales Volume / month Nos.
C) Mention Facilities Available

(1) AREA (2) ANNUAL TURNOVER lac
a) Showroom Sq. m. a) Sales lac.
Frontage Sq. m. b) Spare lac.
b) Spare Parts Sq. m. Average Stock/month lac.
c) Workshop Sq. m. c) Service lac (only labour)
d) Warehouse Sq. m. No. of vehicles serviced/month nos
No. of Field Service Vehicles nos
Automated w/shop Yes No
(if Yes Attach a Photograph)
(3) TOTAL NO. OF STAFF nos. (2) LAND/BUILDING (please tick)
a) Sales nos. Showroom owned leased
b) Spares nos. Workshop owned leased
c) Service nos. Warehouse owned leased
d) Others nos. (please tick)

7. IF DEALING IN 4 - WHEELERS

A) Name of the Co. / Brand dealing with
B) Sales Volume / month Nos.
C) Mention Facilities Available

(1) AREA (2) ANNUAL TURNOVER lac
a) Showroom Sq. m. a) Sales lac.
Frontage Sq. m. b) Spare lac.
b) Spare Parts Sq. m. Average Stock/month lac.
c) Workshop Sq. m. c) Service lac (only labour)
d) Warehouse Sq. m. No. of vehicles serviced/month nos
No. of Field Service Vehicles nos
Automated w/shop Yes No
(if Yes Attach a Photograph)

(3) TOTAL NO. OF STAFF nos. (2) LAND/BUILDING (please tick)
a) Sales nos. Showroom owned leased
b) Spares nos. Workshop owned leased
c) Service nos. Warehouse owned leased
d) Others nos. (please tick)

5

8. FACILITIES PROPOSED FOR HMSI 2 WHEELERS SUB-DEALERSHIP

A) PROPOSED NAME OF THE FIRM
B) CONSTITUTION OF PROPOSED FIRM
C) ADDRESS OF THE PROPOSED LAND / BUILDING

D) EXPECTED ANNUAL SALES VOLUMES AND MANPOWER

Year 1 Year 2 Year 3
Volume
Sales - Sales - Sales -
Service - Service - Service -
Parts - Parts - Parts -
Safety - Safety - Safety -

E) FINANCE

1. How much are you prepared to invest (including land & building) in this sub-dealership?
(Give Maximum Amount)

(Rs. Lacs) (Own % / Bank % )

2. Does the provision of this amount require you to liquidate some assets? YES /NO
If yes, please give details of the assets which would be liquidated and how?

3. Please specify the amount of Working Capital proposed for the sub-dealership?

(Rs. Lacs) (Own % / Bank % )

4. Please furnish the details of other promoters / partners in this sub-dealership

Name of the
stakeholder

Relationship with
main promoter

Years of business
association with
the main promoter

Investment
Amount
(lac)

% of
Equity

Nature of
Involvement
#

Friend? Business Partner / Relative Please Specify
# Shareholder / Director / Active or Sleeping Partner

6

F) LAND/BUILDING

1. Please attach along with this form a city map showing location where you propose to set-up this
dealership

2. Please attach along with this form a detailed site plan (to scale) showing the layout of the
proposed land and the neighbouring area. (Also show exat dimension of the facility in meters)

3. Whether the Land / Building is:
(PLEASE TICK)
Owned
Leased
If Leased, specify rent / month
(Rs. Lacs)
(Please furnish a copy of the ownership/
lease documents. In case they are in local
language, kindly translate the relevant
information in English.)

SHOWROOM
a) Area Sq.m
b) Dimension L x B m.
c) Frontage m.
d) Parking Space Sq.m

PARTS
a) Area Sq.m
WORKSHOP
a) Area Sq.m
WAREHOUSE
a) Covered Area Sq.m

4. How long it will take to make 4S infrastructure ready from the date of LOI? months

5. Do the building byelaws allow you to construct/run a showroom cum workshop on this land?

6. Has any of the promoter / relatives as per family tree been into business of 2 wheelers? If yes,
give details.

7. Have you applied for Honda Dealership ever before? If yes
Location Month/Year of application
Whether interviewed by HMSI Yes No

8. Are you any of your relative are business partners with HMSI? if, please specify
Dealership Sub-Dealership ASC Vendor Stockist Transporter

Duration of association with HMSI Location

7

9. What will be your unique business approach to promote Honda Brand in your area?
(more information can be attached in separate annexure).

8

Kindly share your family tree (3 Generations one above and one below of the main
promoters with age, education and business / profession).

One Generation
Above main promoter

Main promoter
One Generation
Below main promoter
8

1. Please attach two recent postcard sized photographs of the site in the boxes indicated
(More photographs may be attached as annexures)

PHOTOGRAPH - 1

PHOTOGRAPH - 2

9

DECLARATION

1) The applicant certifies that he made full disclosure of all the information required in the application
and all information given by him is true in all respects. He further acknowledges that any
misinterpretation, whether intentional or unintentional. In the information submitted in connection
with the application shall be grounds upon which Honda Motorcycle & Scooter India (Pvt.) Ltd.
(HMSI) may either: (a) Decide to no longer consider his application OR (b) Immediately terminate
any sub-dealership agreement executed by HMSI with him or the dealer company designated by
him.

2) This applicant acknowledges that this is only an application for sub-dealership and by submitting
this application; he will not place any obligation on HMSI to appoint the applicant as an authorized
sub-dealer of HMSI.

3) The applicant certifies that he is not suffering from, or aware of any legal disability that would
prevent him from being appointed as an Authorized Dealer of HMSI.

4) The applicant acknowledges that any obligations undertaken or expense incurred by him in
submitting this application shall be incurred entirely on the applicants own behalf.

5) The applicant hereby authorizes HMSI to make any inquires it may consider necessary to verify
this information and will not consider such inquiry to constitute an invasion of his privacy.

6) The applicant acknowledges that copies of all documents, photographs etc. furnished by him to
HMSI in the process of applying for dealership would henceforth become a property of HMSI and
may retain by them for their records.

7) The applicant hereby authorizes the receipt, provision, verification, and exchange of relevant
credit related information form / with any source including banks, credit rating agencies, credit
bureaus in respect of his personal account as well as business for the purpose of considering his
request.

8) The applicant certifies that he/she never been convicted by court in India for any criminal offence,
hence sentenced to imprisonment preceding the date of application.

DATE:
NAME OF THE APPLICANT: SIGNATURE:

NAME OF THE WITNESS: SIGNATURE:

NOTE: The submission of your Dealer Application Form is only the first step in the process to qualify
for HMSI dealership. Until you are officially informed in writing and are presented with a dealership
Letter of Intent, you are not appointed as HMSI dealer. Only after completion of Terms & Conditions in
the LOI and after due diligence by HMSI nominated Team, we enter into a dealer agreement for official
commencement of Honda Exclusive Authorised Dealer Operations. Until then, you should not rely on
any action or communication from HMSI to the contrary.

10

REFERENCES

REFERENCES 1

REFERENCES 2

REFERENCES 3

NAME

CONTACT NO.

EMAIL ID

PROFESSION

RELATIONSHIP
WITH
APPLICANT

KNOWN SINCE
(NO. OF YEARS)

11

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Honda Motorcycle & Scooter India Pvt. Ltd.

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