Application Form for Distributorship

KERAFED, ARISTO JUNCTION, THYCAUD - P.O., TRIVANDRUM - 695 014. 1. Name and address of Applicant/Company 2. State Whether Proprietorship/ Partnership / Jt.St.Co. 3. Total Ann al T rno!er "for last 3 years# $. %alance Sheet "for last 3 years# &. 'istrict/State preferred for distri( torship ). *nfrastr ct ral +acilities presently a!aila(le a# Nos. of Sales Personnel (# Nos. of ,ehicles c# 'etails of -odo.n / Wareho se /. 'etails of 0ar1etin2 set3 p Specify the hierarchy 4. Sales Ta5 6e2istration 'etails "7-ST / 8ocal ST 9 CST# :. 'etails of Prod cts presently handled a# Prod cts / %rands (# Area of operation c# No. of retailers co!ered 1;. N m(er of stoc1ist and 6etailers "<peration nder yo # : : : : : : : : : : :

: : : : : : i#7era Cocon t oil ii#7era2em 7esamrith her(al oil iii# %oth

11. 'etails of yo r %an1er and facilities (ein2 a!ailed of (y yo 12. 0ode of payment preferred "'emand 'raft/%an1 - arantee# 13. Prod ct for .hich distri( torship re= ire:

PS: Necessary doc ments to s pport information on items 2>3>$>)>/ 9 4 a(o!e sho ld (e prod ced alon2 .ith this application form. Pla ! " Da#! " S$%&a#'(!