VENDOR MASTER CREATION FORM
Legal Entity * LTFC LTHF LTI LTCM LTIM LTFH Others, Please Specify
Title
Vendor Name * SHRISTI AUTOMOBILES
Nature of Service Provided TRACTOR SEALS &SERVICE
Initiator Department MDM
ADDRESS
Plot No / Floor / Bldg Name *
Street Address 1 *
Street Address 2 KRISHI SHAKTI KENDRA,NABABHAT
City * PURBO BARDHAMAN, BURDWAN
State * WEST BENGAL
Pincode * 713104
Contact No (Mobile) * 9903226868
Contact No (Landline)
Fax No
E-Mail Id * Shristi.powertrac@gmail.com
GST Vendor Class * (Ref Note 2 for Unregistered Vendor) Registered Not Registered Compounding Scheme Special Economic Zone
GST NO (if applicable)* 19ALRPB4822D1Z7
PAN NO * (Ref Note 3 for non submission of Pan No) ALRPB4822D
MSME Applicable * YES NO
MSME No. (If Yes)
I / We hereby confirm that whenever we are registered under MSMED Act we will
MSME No. (If No)
ensure to share the registration details with the company.
BANK A/C DETAILS *
Vendor Name As Per Bank A/C SHRISTI AUTOMOBILES
Bank Name AXIS BANK
Branch Name RAJBATI
Bank Address BURDWAN
Bank A/C No 917020068691379
Ifs Code For Neft UTIB0002949
Micr Code 713211104
Payment Method RTGS
Adhaar Card Electricity/Telephone Bill GST Certificate Others
* Proof required for Address (Scan copy)
* Proof required for Bank A/c Details ( Scan copy ) Cancelled Cheque Leaf Copy Copy of Bank Statement (Last 3 months)
Initiator Name * P S No Designation Signature
SAIKAT CHATTERJEE 50035978 FL’s
Approver Name * P S No Designation Signature
PARIMAL RANU 20163259 ASM
Place : BURDWAN Name/Authorized signatory of Vendor –SHRISTI AUTOMOBILES
Date : 07/08/2022 Vendor Signature & Seal :
Declaration I / We hereby declare that the above information is true in all respects and we
* undertake to inform you if any change in the above particulars regarding our
business from time to
time.
Note : - 1) * Marked fields are mandatory.
2) In case of GST Unregistered Vendor, declaration needs to be provided by Vendor on Letter Head.
3) If Vendor has not furnished IT PAN card copy,TDS Income Tax to be deducted @ 20% as per IT provision U/S 206AA of Income Tax Act.