TAX AND OTHER RELATED

Sponsor Present ? *

Yes No

APPLICANT FULL NAME *
DESIGNATION *
MOBILE NO *
E-MAIL ID

I AM A *	- select - Taxpayer Tax Deductor Tax Collector (e-Commerce) GST Practitioner Non Resident Taxable Person United Nation Body Consulate or Embassy of Foreign Country Other Notified Person Non-Resident Online Services Provider
STATE *
DISTRICT *
NAME OF THE BUSINESS * (As mentioned in PAN)
PERMANENT ACCOUNT NUMBER (PAN) * (Eg: A B C D E 1 2 3 4 X)
MOBILE NUMBER *
E-MAIL ID

NAME OF THE BUSINESS *
PAN NO *
TRADE NAME
CONSTITUTION OF BUSINESS *	- select - Foreign Company Foreign Limited Liability Partnership Government Department Hindu Undivided Family Limited Liability Partnership Local Authority Partnership Private Limited Company Proprietorship Public Limited Company Public Sector Undertaking Society / Club / Trust / AOP Statutory Body Unlimited Company Others
STATE *
DISTRICT *
STATE JURISDICTION CHARGE ( Sector/Circle/Ward/Charge/Unit )
COMMISSIONERATE
DIVISION
RANGE
ARE YOU APPLYING FOR REGISTRATION AS A CASUAL TAXABLE PERSON ? *	Yes No
OPTION FOR COMPOSITION *	Yes No
REASON TO OBTAIN REGISTRATION
DATE OF COMMENCEMENT OF BUSINESS ( DD/MM/YYYY )
ANY OTHER EXISTING REGISTRATION	Yes No
TYPE OF REGISTRATION
REGISTRATION NO
DATE OF REGISTRATION ( DD/MM/YYYY )

NAME *
FATHER NAME *
GENDER *	Male Female Trans Gender
DATE OF BIRTH * (DD/MM/YYYY)
MOBILE NO *
E-MAIL ID *
DESIGNATION *
DIN NO
PAN NO *
AADHAAR NO
RESIDENTAIL ADDRESS (FULL) *
PHOTO * Maximum 100 KB With JPG Format

SAME AS PROMOTER / PARTNER ? *	Yes No
IF No, PROVIED NAME
FATHER NAME
GENDER	Male Female Trans Gender
DATE OF BIRTH
DESIGNATION
MOBILE NO
E-MAIL ID
DIN NO
PAN NO
AADHAAR NO
RESIDENTAIL ADDRESS (FULL)
PHOTO
LETTER OF AUTHORISATION / COPY OF RESOLUTION PASSED BY BoD or MANAGING COMMITTEE * For Proof of Authorized Signatory

DO YOU HAVE ANY AUTHORIZED REPRESENTATIVE ? *	Yes No
IF YES, GIVE DETAILS IF Yes, Details are Mandatory
TYPE OF AUTHORIZED REPRESENTATIVE	GST Practitioner Other
GIVE DETAILS

STATE *
DISTRICT *
AREA TYPE *	Rural Urban
POLICE STATION *
CITY / TOWN / LOCALITY / VILLAGE *
ROAD / STREET *
NAME OF THE PREMISES / BUILDING
FLOOR NO
BUILDING NO / FLAT NO *
OFFICE MAIL ID *
OFFICE CONTACT NO *
NATURE OF PREMISES *	- select - Rented Leased Consent Won Shared Others
NATURE OF BUSINESS *	- select - Bonded Warehouse EOU / STP / EHTP Export Factory / Manufacturing Import Supplier of Services Leasing Business Office / Sale Ofiice Recipient of Goods or Services Retail Business Warehouse / Depot Wholesale Business Works Contract Others
IF OTHER, (Please Specify)

HAVE A ADDITIONAL PLACE OF BUSINESS ? *	Yes No
IF Yes, GIVE THE DETAILS

PLEASE SPECIFY TOP 5 SERVICES

PROFESSIONAL TAX EMPLOYEE CODE (EC) NO
PROFESSIONAL TAX REGISTRATION CENTIFICATE (RC) NO
STATE EXCISE LICENSE NO
NAME OF THE PERSON IN WHOSE NAME EXCISE LICENCE IS HELD

MOBILE NO *
E-MAIL ID *

BUSINESS REGISTRATION CENTIFICATE / TRADE LICENCE *
BUSINESS PAN CARD *
BUSINESS ADDRESS PROOF (LEASE/RENT AGREEMENT) *
AUTHORIZED SIGNATORY PHOTO *
AUTHORIZED SIGNATORY ID PROOF * ( Aadhaar card / Votar Id Card / Driving Licence / Passport )
AUTHORIZED PAN CARD *
OTHERS