AEROBOK SHOE MARKETING PVT. LTD.

NEW CUSTOMER CODE (ERP) CREATION REQUEST FORMAT

DATE OF REQUEST:
CUSTOMER NAME & ADDRESS
1

*Customer Name

*Address

*City

District

P.O. Box

*Country

*Postal code

*State

10
11

Regd off. Add

* Please select : Identity - Individual/ HUF/ Partnership/ Company/
Others

12

*Telephone no.

13

Fax No.

14
15
16

*E-mail Address
*Contact Person details (Name,Add., Tel.no, Mob.no, e-mail id)
TRANSPORT
II TAXES*

Tin/ Local Sales tax no.

CST Regd No :

Sales tax form applicable (Form No.)

Entry/ Exit form no, if any

Excise Regd No.

Excise Range

Excise Division

Tariff Heading No.

10

PAN No.

11

Details of Excise Exemption Available (with Notification)

IV COMMERCIAL TERMS

Delivery terms

Freight & Insurance

Jurisdiction

*Credit Limit

6
7

*Currency

*Payment terms

* Fields marked with asterick are mandatory fields

* Scanned copy of PAN Card to be provided.
* If TIN, CST is not available please define the time limit in which that would obtained.
Request raised by (Name & Sign) :
Request approved by (Initiator's Manager/H.O.D.--Name & Sign) :
VERIFIED BY (Name & Sign)
Date of Verification: