Dealer & Distributor

Basic

Business

Financial

Infrastructure

References

Documents

Step 1: Basic Information

First Name *

Last Name *

Email Address *

Area Applied For *

Mobile Number *

Step 2: Business Details

Business Name *

Established Since (YYYY) *

Nature of Business Entity *

Proprietorship

Partnership

Private Limited Company

Other

Proprietor Details

Name *

Father's Name *

Designation *

Residential Address *

Full Address *

State *

Town/City *

Pin Code *

Police Station *

Step 3: Financial Details

GSTIN Number *

Aadhaar Number *

PAN Number *

Annual Turnover Last 2 Years

Year 1 (INR) *

Year 2 (INR) *

Step 4: Infrastructure Details

Warehouse Area (sq ft) *

Cold Storage Facility

Number of Delivery Vehicles *

Number of Staff *

Distribution Network Coverage

Step 5: Business References

Reference 1

Company Name *

Contact Person *

Phone Number *

Reference 2

Company Name *

Contact Person *

Phone Number *

Step 6: Additional Information

Bank Name *

Account Number *

IFSC Code *

Experience in FMCG Distribution (Years)

Why do you want to become a Pushti Nuts dealer?

Additional Comments

Application Submitted Successfully!

Thank you for your interest in becoming a Pushti Nuts dealer. Our team will review your application and contact you within 3-5 business days.

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