Applied For (Segment):

Dealer Evaluation Form

1. Name of the Company

2. Address 1

Address 2

City

State

Pin Code

3. Nature of Organisation

(Partnership, proprietor, Ltd, etc)

4. Website Detail

5. Registration Details

Excise

CST

VAT / TIN

PAN No.

Dealer Policy 2015 – Doc. No. DMS/VLP/040415

 Service Tax Registration No.

6. Associated Companies & relationship thereof

Associated Company Name Relationship

7. Infrastructure
Network of Branch offices, Ware houses and Locations

Location Branch Office / Contact Details

Area Sq Ft
Ware house

8. Other major Companies Represented in Last 3 Years

Turn Over in MINR

Company Product
(Last 3 years)
Name Handeled

9. Total T/O of the company

10. Total T/O of Associate Co.

11. Manpower Details (Nos)

Engineers
Technicians
Others

Dealer Policy 2015 – Doc. No. DMS/VLP/040415

12. Bankers Details

Bank Name / Location CC Limit Bank Managers with

Contact Details

13. Intended Area Coverage

14. Intended Product

(Family/Series)

Documents Required for Agreement

1. Business Limit Request / Approval Sheet
2. Dealer Information
3. Dealer Evaluation Form
4. SWOT Analysis I & II
5. Shop Licence
6. CST / VAT Registration Copy
7. Last 3 Months Bank Statement (stamped by bank) / Solvency Letter by Bank
8. Audited Balance Sheet of Previous 3 Years
9. Dealer Deposit Cheque
10. Partnership Deed or Memorandum and Articles (in case of partnership Or
company)
11. Balance Confirmation Letter
12. PAN Card
13. Service Tax Registration Certificate No.

(Prepared By) (Branch Manager) (Regional manager)

(Name, Signature, date) (Name, Signature, date) (Name, Signature,
date)

(Segment - Head) (Head- Commercial) (V.P. - S & M)

Dealer Policy 2015 – Doc. No. DMS/VLP/040415

(Name, Signature, date) (Name, Signature, date) (Name, Signature,
date)

Dealer Policy 2015 – Doc. No. DMS/VLP/040415