AHMEDABAD MUNICIPAL CORPORATION

Party / Contractor / Service Provider's Enrollment Form

Party Code
(for Office Use Only)
Temporary Reg. No

Registration Class Validity up to

Party Registration Type Firm/Organization Individual

Vendor Type Advocate Contractor Consultant Vendor

Initial Mr. Mrs. Ms. Prof. Dr. Shri

Full Name (Individual)

(Fill in Order of first name,
middle name & last name)
Designation Partner Individual Director Proprietor

Authorized Signatory Others

PAN No.

TAN No.

Full Name (Firm/Org.)

(Only fill if Registration type
is selected as “Firm/Org.” )

Firm Type Partnership Private Ltd. Public Limited Proprietorship

Registered Individual Co-operative Body Others

Permanent Address

City

District

State

Country

Mobile No. + 9 1 -
+ 9 1 -

Land Line
+ 9 1 -
+ 9 1 -
STD – CODE Telephone No

eMail ID - 1

eMail ID - 2
 Correspondence Address: (If not same as Permanent address, required to fill)

City

District

State

Country

Bank Account Detail

Bank Name Branch A/C TYPE Account No. MICR No. IFSC Code

PEC NO.
(Professional Tax Personal)

PRC NO.
(Professional Tax Company)

P.F. Reg. No

E.S.I No

GST No. 1.

2.

3.

Name & Signature of Applicant With Seal

FOR OFFICE USE ONLY

ENTERED BY VERIFIED BY AUTHORISED BY

EMP. NO
DATE

DEPARTMENT

SIGN OF EMPLOYEE

IMPORTANT INSTRUCTION
1 Form to be filled in BLOCK LETTERS ONLY.
2 ALL DATES SHOULD BE IN "DDMMYY" FORMAT
3 Pls. Provide Bank Account's Pass Book/Statement Copy and Cancelled Cheque Copy
4 Please provide PAN NO Copy
5 Please provide E.S.I NO, GST No and P.F.NO COPY IF APPICABLE
6 Please provide Documents Related to Type of Company
For more information e-mail us at fas@egovamc.com OR contact Zonal /Head Office of AMC