YOROZU JBM AUTOMOTIVE TAMIL NADU PVT LTD

Vendor Registration Form

Vendor Code
(to
be entered by Accounts Dept)

Vendor Group

Domestic

General Details
1
2
3

Vendor Name
Nature of Business:
Vendor Type

4
4 a)

Registered Office
Address

4 b)
4 c)
4 d)
4 e)
4 f)

City
Pin Code
State
Phone No
Fax No

Public Ltd

No. 410 100ft Road

4th Block
Koramangala
Bengaluru
560034
Karnataka
080 30213000
080 30213001

5 a)

Factory/Branch Address:
(If applicable)
Address

5 b)
5 c)
5 d)
5 e)

City
Pin Code
State
Phone No

6
6 a)
6 b)
6 c)
6 d)

Contact details:
Name
Phone No (with Extn, if any)
Mobile No
E Mail ID

7
8 a)
8 b)
8 c)
9
10
11
12
13

PAN No.
Excise Reg No.
Excise Range
Excise Division
Service Tax No.
VAT TIN
CST No & Date
PF Reg No.
ESI Reg No.

Essae-Teraoka Limited
Company Status:
Others

Manufacturing

Plot No. 4B
Bommasandra Industrial Area
Bangalore
560099
Karnataka
080 - 30999100
Head of Establishment
S K Renuka Prasad
080 3021 3009
09342255989
info@essae.com

User Dept

Statutory information (Please fill whichever is applicable to this vendor)

AAACE3061A
Yes
AAACE3061AXM001
Yes
Hebbagodi-E-Wing
Yes
Bangalore-III-C-Wing
Yes
AAACE3061AST001
Yes
29400058768
Yes
29400058768
Yes
Bangalore-III-C-Wing
Yes
53-8659-67
Yes

Accounts Dept

Proof Enclosed (Please

tick whicever applicable)

Bank Details
12
13
14

Vendor Name ( As Appear in Bank )

Bank Name
Bank Address

15
16
17
18
19
20
21
22

Branch Name
Account No
Account Type
RTGS Code
IFSC Code
Swift Code
MICR No
Branch Code

23 Payment terms:
23 a) Mode of Payment

Details enclosed

25% in advance balance against delivery

RTGS
(If mode of payment is cash, please obtain prior approval from Management)
23 b) Credit Period
as per requirement
(Credit period for Raw Material, Parts & Regular items cannot be less than 60 days)
24 Any other information
-

Prepared by

Purchase Dept

Authorised by

HOD-Purchase

Checked by

Accounts Dept

Test 1

60

Page 2

YOROZU JBM AUTOMOTIVE TAMIL NADU PVT LTD

Vendor Registration Form
Vendor Code
(to
be entered by Accounts Dept)
General Details
1
2
3

Vendor Name
Nature of Business:
Vendor Type

4
4 a)

Registered Office
Address

4 b)
4 c)
4 d)
4 e)
4 f)

City
Pin Code
State
Phone No
Fax No

Essae-Teraoka Limited
Manufacturing
Others

No. 410 100ft Road

4th Block
Koramangala
Bengaluru
560034
Karnataka
080 30213000
080 30213001

5 a)

Factory/Branch Address:
(If applicable)
Address

5 b)
5 c)
5 d)
5 e)

City
Pin Code
State
Phone No

6
6 a)
6 b)
6 c)
6 d)

Contact details:
Name
Phone No (with Extn, if any)
Mobile No
E Mail ID

7
8 a)
8 b)
8 c)
9
10
11
12
13

PAN No.
Excise Reg No.
Excise Range
Excise Division
Service Tax No.
VAT TIN
CST No & Date
PF Reg No.
ESI Reg No.

Chalta No.10
Street no. 8
Chandrawada Fatorda
Margao Goa
403602
Goa
0832-3294037
Head of Establishment
S K Renuka Prasad
080 3021 3009
09342255989
info@essae.com

Statutory information (Please fill whichever is applicable to this vendor)

AAACE3061A
AAACE3061AXM003
Fatima Building, Margao (Code No.
Div-II, MIDAS Touch Bldg, 3rd Floor
AAACE3061AST001
30951106340
MCST/7144
KN/13423
53-8659-67
Bank Details

12
13
14

Vendor Name ( As Appear in Bank )

Bank Name
Bank Address

Details enclosed

15
16
17
18
19
20
21
22

Branch Name
Account No
Account Type
RTGS Code
IFSC Code
Swift Code
MICR No
Branch Code

23 Payment terms:
23 a) Mode of Payment

25% in advance balance against delivery

RTGS
(If mode of payment is cash, please obtain prior approval from Management)
23 b) Credit Period
as per requirement
(Credit period for Raw Material, Parts & Regular items cannot be less than 60 days)
24 Any other information
-

Prepared by

Purchase Dept

Authorised by

HOD-Purchase

VE TAMIL NADU PVT LTD

tration Form
Vendor Group

Domestic

Details
Essae-Teraoka Limited
Company Status:
Others

Public Ltd

No. 410 100ft Road

4th Block
Koramangala
Bengaluru
560034
Karnataka
080 30213000
080 30213001

Chalta No.10
Street no. 8
Chandrawada Fatorda
Margao Goa
403602
Goa
0832-3294037
User Dept

ichever is applicable to this vendor)

Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes

Details
Details enclosed

Accounts Dept

Proof Enclosed (Please

tick whicever applicable)

gainst delivery

RTGS
e obtain prior approval from Management)
as per requirement
& Regular items cannot be less than 60 days)
-

Checked by

Accounts Dept