CUSTOMER CREATION FORM

Name Of Customer VARUN MERCANTILE

Billing Address of Business

Street Houe No. 421
Street 2 MOHIBULLAPUR, SITAPUR ROAD
Street 3
Pin Code 226021
City LUCKNOW State UP
Country India

Corresponance Address:
Street House No. 421
Street 2 MOHIBULLAPUR, SITAPUR ROAD
Street 3
Pin code 226021
City LUCKNOW State UP
Country India

Contact Person Designation PROPRIETOR - AMIT AGARWAL Fax No. NA

Telephone No. NA
Mobile No. 9415108688
E-Mail varunmercantilenh24@gmail.com

Nature of Customer MANUFACTURER

STATUS OF CUSTOMER
UNDER GST- NORMAL/JOB
NA
WORKER/
E-COMMERCE/COMPOSITIO
N/ CO WORKER)
 TAX DETAILS
PAN NO. (enclosed copy) AGEPA8846Q
GST REGISTRATION DETAILS

STATE UP

ADDRESS VARUN MERCANTILE, 421, MOHIBULLAPUR, SITAPUR ROAD, LUCKNOW

GST Number 09AGEPA8846Q1ZQ
Application Reference
Number NA

Principal Place of Business LUCKNOW

CIN No. (in case of
Company) NIL

PWMR no.
(Plastic waste management
rules) NA
Customer Type
(Manufacturer/ Trader) MANUFACTURER

BANK DETAILS
NAME OF THE BANK YES BANK
BRANCH TULSI COMPLEX, HAZRATGANJ, LUCKNOW
BANK ADDRESS TULSI COMPLEX, HAZRATGANJ, LUCKNOW
ACCOUNT NO. 1863300006172
IFSC CODE YESB0000018
MICR CODE 226532002

DECLARATION

I/We hereby confirm that the particulars given above are correct and complete and also undertake to
promptly advise of any changes to the above details to Vacmet India Limited. I/We agree to accept the
supply of goods supplied by Vacmet India Limited against my/our purchase orders placed written/verbal.

For VARUN MERCANTILE

SEAL
Proprietor

AMIT AGARWAL
Name

Date 29.06.2021 Place LUCKNOW

FOR SALES REPRESENTATIVE

Sales Representative Name
Party Group (if relates to any
Group)
Any Other Remarks