APPLICATION FORM FOR MARKETING AGENT

Nature of the Applicant (Required if the Applicant is an entity):

Name of the Applicant:

Sex:

Mobile Number:

Date of Birth (DD/MM/YY):

Home Number:

PAN/AADHAR:

Business Number:

E-mail:

Address:

Name of the Bank:

Branch:

Address:

City:

Account No:

IFSC Code:

Payment of Application Fee: INR 2,500/- (Comprising of INR 2,000/- worth [Product Details]
along with Application Fee of INR 500/-)

Method of Payment:

This Application constitutes the contractual Offer of the undersigned individual(s) or legal entity
(through its authorized signatory(ies), as applicable, addressed to XYZ Ltd. to enter into a
Marketing Agent Agreement with XYZ Ltd. under the Terms and Conditions specified below
this application form. The Applicant hereby certifies that he/she/it is legally competent to do
business in India and is not bound by any legal requirement restricting or prohibiting his/her/ its
appointment as XYZ’s Marketing Agents. The Applicant shall bear the liability for his/her
actions connected with the marketing of the Product for which this application is made.
By signing this Application, I confirm that I shall undertake an Orientation Program to be
conducted by XYZ Ltd. which shall provide fair and accurate information on all aspects of
XYZ’s Marketing Program, its Commission system, product details, its refund and return policy,
expected commission and related rights and obligations as governed under the XYZ’s Code of
Ethics and Rules of Conduct. I further understand and agree that only on successful completion
of the Orientation Program and after being evaluated by XYZ Ltd., I shall be appointed as the
Marketing Agent of XYZ Ltd. and thereafter I shall be required to sign any further documents
with regard to such appointment. I further understand and agree that this application and any
ensuing Marketing Agency upon acceptance of this application and after evaluation by XYZ Ltd,
after the said Orientation Program, shall be subject to the Terms and Conditions given below
including the constituent documents as amended from time to time. Furthermore, I understand
and agree that my information provided in connection herewith may be used in accordance with
XYZ’s Privacy Policy available at www.XYZ.in. I am signing this application under my own
free will.

Signature : ............................................... Date :

Place ..............................

For office use only

Date: __________________

Application received on: ____________ From Mr./ Ms. /Mrs./ Dr./

Prof./________________________ ______________________________________Application
Fee received on:____________ Approval dated: ____________________ Receipt
No.:____________________ For Rs _________________ (In Words )
______________________________________________________________________________
toward s
______________________________________________________________________________
____ Through _____________DD No________________ Dated ___________________ Drawn
on ________
______________________________________________________________________________
______
 TERMS & CONDITIONS
These Terms and Conditions are to be read together with the Marketing Agent Application (the
“Application”). They become binding if and when XYZ Limited (the “Company”), in its sole
discretion, accepts the Application.

1. Definitions:
a) Definitive Agreement: shall mean the Agreement to be signed between the
Applicant and the Company on completion of the Orientation Program and after
being evaluated and approved by the Company, at its discretion.
b) Marketing Agent: shall mean a person appointed by the Company on a principal-
to-principal basis vide this Application and being evaluated and approved by the
Company, at its sole discretion, after the completion of the Orientation Program,
in order to undertake marketing of the Company’s products and services.
c) Orientation Program: shall mean a mandatory training session to be conducted
by the Company in order to train the Applicants about the Products/services of the
Company, its marketing polices, methodology to be adopted, its remuneration
systems and any other aspect associated with the marketing of the Company’s
Product/Services.
d) Products/Services: [Include definition]
e) Appointment: shall mean the appointment of the Applicant as the Marketing
Agent after the completion of the Orientation Program and after being evaluated
and approved by the Company, at its sole discretion.
f) Territory: shall mean the Republic of India.
g) Effective Date: shall mean the date of submission of the duly filled Application,
subject to approval by the Company.
2. Scope:
The Company, as of the Effective Date, considers the individual(s) identified in the above
Application, and mandates him/her to undertake the Orientation Program and the
Applicant agrees to undergo such Orientation Program. Upon completion of the
Orientation Program and being evaluated and approved by the Company, the Applicant
shall be appointed as the Marketing Agent, on a non-exclusive basis, within the Territory
as may be communicated by the Company, and otherwise in accordance with the
Definitive Agreement to be signed between the Applicant and the Company, purchase the
Company’s Products from the Company in order to market the same.
3. Duration:
This Terms and Conditions shall remain valid and continue to remain in full force unless
terminated earlier by either Party with or without cause, as provided in Clause 10 of this
Terms and Condition or till the signing of the Definitive Agreement. The Applicant
understands that his/her acts, or lack of action, which may result in a misuse,
misrepresentation, or violation of the Company’s policy can cause the termination of this
 Application by the company without any liability of whatsoever nature on Company’s
part and with immediate effect.
4. No Employment Relationship:
The Applicant hereby confirms that he/she has signed this Application and agrees that on
Appointment he/she shall be appointed on an independent contractor basis and not an
employee, partner or legal representative of the Company for any purpose whatsoever.
Nothing in this Applicant or in any other document created for this purpose shall
establish either an employment relationship or any other labour relationship between the
Parties or a right for the Applicant to act as a procurer, broker, commercial agent,
contracting representative or other representative of the Company. The Applicant will be
responsible for his/her own business, and the compliance of the Central, State and Local
Statues and regulations and all applicable laws, including but not limited to, those
relating to licensing a direct and indirect taxation.
5. No Assignment:
This Application is intuitue personae signed on a personal basis, and neither this
Application nor any of the rights or obligations of the Applicant arising hereunder may be
assigned or transferred without the prior written consent of the Company.
6. Completion:
The Applicant agrees that he/she shall mandatorily undergo the Orientation Program. On
completion of such Orientation Program and after being evaluated and approved by the
Company, he/she shall be appointed as the Marketing Agent by the Company in order to
market the Products/Services of the Company. On being appointed as the Marketing
Agent, a definitive agreement should be signed by the Parties and the Company shall
provide a one-time support fee, amounting to INR 17,100/- to such Marketing Agents in
order to market the Products/Services of the Company. The Applicant’s can in no way
claim such amount prior to signing of the Definitive Agreement.
7. Amendment of the Policy:
The Company may at any time, after reasonable notice, change, amend, add to, or modify
this Terms and Condition and/it’s Company policy to maintain a viable marketing system
comply with legal requirements and changes in economic conditions, and the Applicant
shall be bound and shall operate his/her business in accordance with any such changes,
amendments additions or modifications.
8. Obligation of the Applicant:
a) The Applicant agrees to abide Company’s policies procedures and marketing plan
(“Company Policy”) and agrees to operate his/her business in accordance with the
Company policy as amended by the company from time to time.
b) The Applicant shall properly represent the Company products in accordance with
the Company policy. All forms of advertising, including but not limited to audio
and visual tapes and printed material, must be submitted and approved in writing
by a Company authorized representative prior to its use.
 c) The Applicant shall, throughout the validity of this Terms and Conditions and
thereafter, strictly adhere to all applicable laws, regulations and other legal
obligations that affect the operation of his/her business. The Applicant shall be
responsible for obtaining any applicable registration, license, approval or
authorization, to carry out the business as Marketing Agent, copy of which shall
be provided to the Company upon request.
d) The Applicant mandatorily shall undergo the Orientation Program, in the event of
failure to do so shall disentitle him/her to become a Marketing Agent for the
Company
9. Payment:
The Applicant shall pay a non-refundable application fee of INR 2,500/- towards this
Application, wherein he/she shall receive a ____[Product details] on payment of the full
amount along with Company’s Brochure and other Training Materials.
10. Termination of the Marketing Agent Contract:
The Applicant may without assigning any reason, after giving 14 days prior written
notice to the Company terminate this Contract with immediate effect and this Contract
would be terminated automatically. The Applicant shall not be entitled to undergo such
Orientation Program upon serving the notice. In addition to the above, The Company
may terminate this Terms and Conditions forthwith in case and without liability of any
nature whatsoever:
a) if the Applicant is in breach of any of the terms of this Application and/or the
Company Policy, or
b) if the Applicant is responsible for any of the acts prohibited in the Company
Policy, or
c) in case of breach of any applicable laws, rule or regulations, or
d) The Applicant has become bankrupt or insolvent or enter into liquidation or a
receiver is appointed to his/her assets or
e) if the Company should for any reason arrive at the decision that the Applicant
should not be Appointed as its Marketing Agent.
11. Intellectual Property:
The Applicant agrees to use the trademarks, trade names and logos relating to the
Products/Services only in the registered or agreed style in connection with the marketing
and sale of the Products/Services and shall not use such trademarks, trade names or logos
in connection with any other products or services or as part of any corporate or any trade
name. The Applicant recognizes and agrees that all intellectual property rights in or
relating to the Products/Services including the trademarks, trade names, logos, copyrights
and patents (“Intellectual Property) are and shall remain the sole and absolute property of
the Company. The Applicant shall cease the use of the Intellectual Property from the time
this Application is terminated and shall not use or adopt any mark, name or logo
 deceptively similar thereto at any time thereafter and shall notify the Company of any
illegal or unauthorized use of any Intellectual Property.
12. Confidentiality:
The Applicant shall not use or divulge or communicate to any person (other than as
permitted or contemplated by this Agreement or with the written authority of the
Company or as may be required by law) any confidential information concerning the
products, customers, business accounts, finances or contractual arrangements or other
dealings, transactions or affairs of the Company which may come to his/her knowledge
during the Orientation Program. Obligation shall continue after the termination or
expiration of this Terms and Conditions.
13. Limitation Of Liability:
The Applicant agrees that under no circumstances shall the company or its affiliates be
liable for any consequential, direct or indirect or incidental loss or damage howsoever
caused or arising (including contract, negligence, strict liability or otherwise) from the
quality, performance, merchantability, durability or fitness of the products, and all
warranties, conditions and undertakings are hereby excluded.
14. Indemnity:
The Applicant agrees to hold harmless and indemnify the Company against any loss,
damage or expenses, including reasonable attorney’s fees, suffered by and any claims,
suits or proceedings brought against the Company which arise out of or in connection
with the performance or failure of performance by the Applicant of any covenants,
obligations or responsibilities contained in this Terms and Conditions.
15. Force Majeure:
Neither Party shall be liable for any loss or damage of any nature incurred as a result of
any failures or delays in performance due to any cause or circumstances beyond its
control. This includes, but not by way of limitation, any failure or delays in performance
caused by any fire, act of God or the public enemy, riots incendiaries, interference by
civil or military authorities, compliance with the laws, orders or policies of any
governmental authority which events directly affect the performance of obligations of a
party under this Agreement.
16. Severability:
If any provision of these Terms and Conditions is declared invalid or unenforceable, the
remaining provisions shall remain in full force and effect.
17. Notices:
Any notice required or authorized to be given hereunder, except for routine and typical
documentation, shall be served by certified letter return receipt requested or by telex/
facsimile addressed to the Company or the Applicant (as the case may be) at the
applicable address. Any notice so given by letter shall be deemed to have been served
seven (7) days after the same shall have been posted, not including the day of posting and
any notice given by telex/ facsimile shall be deemed to have been served on the day of
 sending the message. Proof that such letter was properly addressed and put into the post,
and in the case of the telex/facsimile that the message was sent to the correct
telex/facsimile numbers shall be conclusive evidence of service. Notice required by this
Agreement shall be addressed to any other address may be specified by either party by
written notice to the other.
18. Waiver:
Failure by any party to exercise any of its rights under this Application in one or more
instances shall not constitute a waiver of those rights in another instance. Waiver by a
party of any of the rights established herein shall not be considered as a waiver of another
right established herein.
19. Interpretation:
The headings of the articles, clauses and paragraphs of this Application are inserted for
convenience only and shall not affect the construction of the terms of this Application.
Capitalized words not expressly defined herein shall be constructed in accordance with
the meaning ascribed to them in the Company Policy.
20. Governing Law:
This Application and the terms and conditions shall be governed by and construed in
accordance with the laws of the Republic of India, without regard to its principles of
conflicts of laws.
21. Dispute Settlement:
The parties shall endeavor to settle any dispute or difference arising out of or in
connection with this Application through mutual discussions within 30 days of such
dispute arising. Any dispute, difference or claim remaining unresolved post discussion
shall be submitted to binding arbitration under the provisions of the Indian Arbitration
and Conciliation Act, 1996. The venue of such arbitration shall be at Bangalore and the
award of the Arbitrator shall be final and binding on all Parties. Subject to the above,
Courts at Bangalore shall alone have jurisdiction in relation to the Application and
matters connected here to.

Signature : ............................................... Date :

Place ..............................