Application Form

Become a member!

Registered Office Address

Address Line 1

Address Line 2

City

Pincode

Contact Person

Full Name

Mobile Number

Email Address

Own Rented

Store/Billing Address

Address Line 1

Address Line 2

City

Pincode

Store In-charge

Full Name

Mobile Number

Email Address

Own Rented

Annual Turn Over

2015-2016

2014-2015

2013-2014

Branch Name

Bank's Phone Number

Account Number

IFSC Code

Signatory Details

Name

Designation

Signature

Official Seal

* The applicant undertakes to provide advance intimation before closure of any Bank A/c from which cheques have been issued.

Accountant

Name

Mobile

Email Address

Financial Head

Name

Mobile

Email Address

Purchasing Officer

Name

Mobile

Email Address

Sales Manager

Name

Mobile

Email Address

Name

Educational Qualifications

PAN Card Number

Passport Number

Res. Phone Number

Address Line 1

Address Line 2

City

Pincode

Asset Details (Copy of proof to be submitted)

Building

Land

Car

Liability Details

Details of Loan

Father's Name

Occupation

Phone Number

Spouse's Name

Occupation

Phone

Thumb Impression

Name

Educational Qualifications

PAN Card Number

Passport Number

Res. Phone Number

Address Line 1

Address Line 2

City

Pincode

Asset Details (Copy of proof to be submitted)

Building

Land

Car

Liability Details

Details of Loan

Father's Name

Occupation

Phone Number

Spouse's Name

Occupation

Phone

Thumb Impression

Name

Educational Qualifications

PAN Card Number

Passport Number

Res. Phone Number

Address Line 1

Address Line 2

City

Pincode

Asset Details (Copy of proof to be submitted)

Building

Land

Car

Liability Details

Details of Loan

Father's Name

Occupation

Phone Number

Spouse's Name

Occupation

Phone

Thumb Impression

Trade References

SN	Company	Credit Limit	Credit Days	Reference Person

Terms and Conditions of Dealership

Terms and mode of payment shall be as may be mutually agreed upon between BigC and dealer from time to time.
For every purchase dealer should give a correct purchase order and cheque. BigC may not deliver the goods without PO and correct cheque.
The dealer should sign and seal a copy of the invoice on receipt of material from BigC goodown. It is mandatory that dealer / representative should verify the bill, material and serial no. of the products. BigC shall not be responsible for any loss or damage caused to the goods once a dealer takes delivery at BigC warehouse.
The dealer should honor the cheque on the date. No request for holding the cheques will be entertained within three days of the due date. If any cheque need to hold for more than a day BigC will charge 24% interest annually.
If any cheque dishonored, the credit facility will be immediately suspended. For every cheque BigC will charge Rs 500/- as bouncing charge and 24% interest till the payment received. Credit reapproval shall be at the sole discretion BigC.
All warranty and DOA support is provided as per the vendors rules and regulation only. The dealer should not block payments due to BigC in any circumstances because of any dispute with the vendor parties.
Disputes which cannot be settled amicably will be governed by the laws of India and the parties hereby submit to the Courts at Bengaluru, Karnataka.

Statement

I hereby certify that the information I have provided in this form is correct to the best of my knowledge and belief.

Name Designation

Signature

Official Seal

Supporting Documents

Copy of TIN and PAN
Copy of Last Three Months' Bank Statements
Copy of Partnership Deed if Partnership Firm
Copy of Memorandum & Articles of Association if Pvt Ltd.
Visiting Card
Copy of Permanent residence proof
Security Cheque

For Office Use Only

Office visited and data collected by

Credit Days Approved

Credit Limit Approved

Approved by

Signature

Date