For Internal Use Only

Date:

To,

DSM Shared Services India (P) Ltd.

Unit No 3, 9th Floor, Building No 20 (Zenon),
Raheja Mind Space IT Park, Hi Tec City,
Madhapur, Hyderabad- 500081

Legal Name -Company Name-

Trade Name -Please fill-
Constitution Public Limited Company/Private Limited company
/Partnership/Proprietor
Vendor/ Customer State -Please fill-
State Code -Please fill-
Name of GST Related Matters Name & Phone number
Contact
Person & Mail ID -
Contact Other Matters Name & Phone number
Details

Mail ID -
Address for Communication -Please fill-

Bank Details Bank Name :

Branch :
Account Type :
Account No. :
IFS Code :
MICR Code :
SWIFT Code:
GST Number Please fill-
PAN No. Please fill-
TAN No. Please fill-
Service Accounting Code /HSN Please fill-
Service Description / Nature of Service Please fill-
Micro/Small/Medium Registration No. Please fill- (If any)
Contact person Name in DSM

We hereby declare to inform the DSM Shared Services India Pvt Ltd of any changes/modification in the
above-mentioned details.

Encl: Copy of:

 For Internal Use Only

1) Incorporation Certificate/ Registration certificate

2) GST Registration Certificate & LUT
3) Cancelled Cheque
4) PAN Card
5) TAN
6) MSME registration (if any)

We hereby declare that the particulars given above are correct and complete. If the transaction is
delayed or lost because of incomplete or incorrect information we would not hold the
company/institution responsible.

NOTE:
1. We enclose a photocopy of the cancelled cheque to enable you to verify the account
number as mentioned above.
2. LUT is Mandatory as DSM is located in SEZ unit
3. Attach copy of MSME certificate, if applicable – Response is mandatory.
4. Information must be sent on supplier letterhead -signed & stamped.
5. Pls attach soft copy of filled form for internal data compilation.

Thanking You,

For (Company/Firm/Proprietor business name)

Authorized Signatory