Provisional ID: BRG246AN

GLAZE TRADING INDIA PRIVATE LIMITED

HO. : A1/175, Main Najafgarh Road, Janakpuri, N. Delhi-58
Tel : 011- 46277200, 45602164, 41582231 Fax : 011-41582228
www.glazegalway.com

DIRECT SELLER APPLICATION FORM

(PLEASE FILL THE FORM IN BLOCK LETTERSONLY)
Please complete this free of charge Direct Seller Application form in English (uppercase) for appointment as a Direct Seller - of
Glaze Trading India Private Limited. All fields are mandatory except those which are specifically mentioned as optional. An
Applicant must be at least 18 years of age or above and competent to contract as per Indian Laws. Please ensure that all
information furnished in the Application Form along with the supporting documents is true and correct to avoid rejection. By signing
& submitting this Application Form, the applicant agrees to abide by the Terms and Conditions. Acceptance of this Direct Seller
Application Form is at the sole discretion of Glaze.

NAME OF THE APPLICANT (Mr/Ms):

PARDESHI SIRSAM

Father's/Husband's Name:
CHHATIRAM SIRSAM

Gender : MALE Date of Birth : 01/01/1984

POSTAL ADDRESS:
AT-PINDRAI,PS-KURAI,DIST-SEONI,480881

Town: PIPARWANI OTHER INFORMATION

District: SEONI Mobile no.: 8305539794

State: MADHYA PRADESH E-mail ID: SIRSAMARVIND866@GMAIL.COM

Pin Code: 480881

Pan No.:

Documents Uploaded : AADHAR CARD Personal Identification No.: 668573535828

a) SPOUSE NAME: Date of Birth :

b) NAME OF CO-APPLICANT: Date of Birth :

SPONSOR'S PARTICULARS (Mr/Ms) :

Sponsor Code : Sponsor Name :
BRG289AL DIPAK MITHUN MANDAL
DECLARATION: Sponsor's Signature
I declare that the applicant is known to me.
I have explained the entire Terms and Conditions of Glaze distributorship in vernaculars to the Applicant.

UPLINE'S PARTICULARS(Mr/Ms):
Upline Code : Upline Name :
GTI773BC BSUDEV NAYAK
Parent Franchisee Code : Parent Franchisee Name : Upline's Signature
RG143BC5 MD JAWED ALAM
DECLARATION:
We have explained the entire Terms and Conditions of Glaze distributorship in vernaculars to the Applicant. Franchisee Signature

Date : 27-APR-2024 Place : MADHYA PRADESH

Applicant's Signature FOR OFFICE USE ONLY

Prov Dist ID :
BRG246AN DATE RECEIVED :
CHECKED BY :
 Declaration By Direct Seller On Successful Submission Of Online Direct Seller Application & Agreement
Declaration by Direct Seller:
I PARDESHI SIRSAM S/D/o CHHATIRAM SIRSAM aged 40 Years resident of AT-PINDRAI,PS-
KURAI,DIST-SEONI,480881,,PIPARWANI,Seoni-480881 Solemnly declare that I know my Sponsor Mr./Ms. DIPAK
MITHUN MANDAL for More than 3 Years S/D/o MITHUN MANDAL having Direct Seller ID BRG289AL
who is my Relative and he gave me business presentation on dated 27-Apr-2024

I PARDESHI SIRSAM S/D/o CHHATIRAM SIRSAM make the undermentioned declaration on my own free will without any
pressure, fear, favour or under any undue influence :-
1. I understand that Glaze Trading India Private Limited is a Direct Selling Company registered under the Indian Companies Act, 1956 having its registered
office in Delhi.
2. I Understand that Glaze is engaged in the Sale and Marketing of FMCG products in multiple categories like personal care, skin care, homecare, nutrition,
plant growth activators etc.
3. I Understand that Direct Selling envisages an alternate distribution channel for the sale and marketing of products and services through direct sellers in
non-store retail format.
4. I understand that Direct sellers are independent contractors who purchase products from the company at wholesale prices and sell it to customers at
retail.
5. I understand that All incentive paid by the company are factored on product sales. No income or incentive is paid solely for the act of recruitment. Glaze
business opportunity is not an investment scheme, money collection or circulation scheme, recruitment scheme to make easy money or money
circulation.
6 I understand that Glaze business opportunity is an invitation of offer to individuals to join as a Direct Seller to promote its direct selling business. There is
no requirement or pre-requisite to purchase any sales aid or products of Glaze for becoming a Direct Seller.
7. I understand that Direct Seller Application Form and Agreement is free of any charge.
8. I declare that that I am above 18 years as on date of submission of the Online Direct Seller Application and Agreement form.
9. I state that I am legally eligible and qualified to do the Direct Seller business in India and to enter into a business agreement with Glaze.
10. I state that I have no criminal history viz. there are no criminal cases pending against me where I have been convicted, a charge sheet stands issued or
there is any pending FIR against me.
11. I state that there are no bankruptcy or insolvency proceeding pending against me.
12. I state that my sponsor bearing Direct Seller ID BRG289AL has explained me all the material terms of the agreement in my mother tongue and I
have personally gone through the entire agreement before its submission. I have signed / affixed signature only after understanding all the terms and
conditions of the Direct Seller Agreement.
13. I confirm that I know my sponsor and I have full faith in him to guide me in my business prospects as an Independent Direct Seller to sell Glaze Products
and Services and develop my network.
14. I understand that I have applied for becoming a Direct Seller of Glaze Trading India Pvt. Ltd. (Company). I agree that after my Direct Seller Application is
submitted in the Online Portal of Glaze, a provisional Direct Seller Code stands allotted to me and I can purchase the products at a discounted prices and
can sell it further to customers as per the sales and marketing plan of the company. I understand that presently, I have been granted a limited, temporary
revocable right to buy and sell Glaze Products till the Application is duly verified and accepted by the Company, which is also subject to Sponsor’s and
Upline’s consent.
15. I understand and agree that Company is not offering or providing any employment, Job, salary, fixed income to me either permanent nor temporary.
16. I understand that by submitting this application, I am not becoming Company’s agent, partner, employee or representative etc. I am only becoming an
Independent Direct Seller to sell Company Product under Direct Selling Model/System.
17. I understand and agree that Company is not charging any fee/money from me for becoming a Direct Seller or in the name of any service or otherwise. If
any person asks for any kind of fee from me in the name of the Company, offering Jobs etc. or in the name of anyone else, then I will not give any money to
him/her and report such incident to the Company immediately on Customer Care Number and E-mail. However, if I still pay any such unauthorized
fee/money by whatever name, I will be solely responsible for the same. Company will not be held responsible for my wrongful act.
18. I confirm that I have provided true and correct details in this Application Form, proper signature KYC documents (i.e. Aadhar, Passport, Driving License,
Voter ID PAN Card etc.).
19. I do understand and agree that Acceptance of this Direct Seller Application Form is at the sole discretion of Company. Wrong / Incorrect submission of
KYC, or Incorrect Information filled by me in the Form will lead to cancellation of Provisional ID and forfeiture of all benefits.
20.I understand and agree that the Contact details i.e. Mobile Number and E-mail Id provided by me in this Application Form is recorded by the Company
and considered as my registered contact details until amended / updated by me. I take the full responsibility in securing my passwords and unauthorized
access to my Mobile and E-mail Id.
21. I understand and agree that my information may be used in accordance with Glaze Privacy Policy.
22. I understand and agree that I am fully responsible for all links, SMS, notices, transaction details etc. and communication exchanged through my
registered contact details and I will be accountable to keep a check on the same. Any misuse done through registered contact details is my sole
responsibility.
23. I understand and agree that Company upon acceptance of my Direct Seller Registration Form will send important links on my registered contact
details which may contain Orientation Program (Company Introduction, business guidelines, Application Form Terms and Conditions), Company Sale and
Marketing Plan, Rules and Regulations, Product Training and Website Details and Trainings etc. in multi languages through which I can understand my
business in-detail.
Applicant Signature
24. I understand and agree that after becoming Direct Seller of the Company, I am entitled to view and attend all training programs offered by Company
either in Video Format or PDF available on its Website www.glazegalway.com including Direct Seller Orientation Program, Product Refund and Return
Policy, Product Purchase and Buy Back Policy, Sales and Marketing Plan. Incentive Policy etc. I will view all of these within 20 days’ which is called as
“Cooling off period” (i.e. 20 Days from the date of Joining). In case I decide to quit/terminate the business contract I can do the same. During the Cooling-
Off period, I can return all unsold inventory purchased during the first 20 days from the date of joining which are in a saleable condition against full refund
without any deduction and get my I.D terminated.
25. I understand and agree that Company has provided me a right to sponsor New Direct Sellers and to create a sales team of Direct Sellers subject to
Sponsor’s and Upline’s consent.
26. I understand and agree that Company provides me authority to accept or reject Prospective Direct Sellers who in future want to join in my Network of
Direct Seller Team (also called “Sale Team”).
27. I agree to impart training to every existing and prospective Direct Seller who wishes to join my Network or Sales Team about Company’s Business, Terms
and Conditions, Rules and Regulations, Sale and Marketing Plan, Product Detail, Working Method, business training etc.
28. I confirm that I have read/viewed, understood and agreed to the Glaze Direct Selling Business Opportunity Program/meeting of the Company.
29. I hereby affirm, confirm and declare that I have read and I have been explained in my vernacular language, the aforesaid declaration contents and the
nature of Direct Selling Business with Glaze.
30. I understand that the Incentive that I may earn on product sold by me and my sale team is described in the Sales and Marketing of Glaze.
31. I understand that for the business which I will do in any month, I may receive incentives which will be made available to me on or before the last day of
the subsequent month and payment there against will be received through Bank Transfer / e-points credit.
32. I understand that, all incentives will be paid after the deduction of statutory dues and taxes like TDS. (Tax Deduction at Source).
33. I understand that I have to submit valid invoice of my incentive entitlement under GST to the company, copy of GST and PAN registration under Income
Tax Act as per the applicable statutory norms.
34. I understand that my Bank Account has to be in the same name as my KYC and Direct Seller name registered with the company.
35. I understand that I cannot sell Glaze products for a price more than Maximum Retail Price (MRP).
36. I understand that Glaze reserves the full and absolute right, at any point of time, even without any prior notice to change/vary/amend products, products
price and IP. the Glaze Distributorship Rules and Regulation, Code of Ethics, Sales & Marketing Plan, Rule of Conduct, Product presentation of company.
37. I have understood that Glaze has the full and absolute right to suspend or terminate my Distributorship in case I do not comply with the rules and
regulation, Code of Ethics, Sales & Marketing Plan, Rule of Conduct, Product presentation given on Glaze’s Website.
38. I understand that I shall not be involved directly or indirectly (Including by proxy) in the promotion or activities of any other Direct Sales Company or any
other activities that will bring negative effects to Glaze.
39. I know that I can contact the Customer Care Centre of the Company for seeking the solution of problems related to my Glaze Business. I can contact
customer care from 10.30 AM to 6.00 PM (Sunday & other weekly off) or cc@glazegalway.com . The phone number is 011-46277200. It is
important to take the complaint reference number after you register your complaint.
KYC Details: KYC Type :- AADHAR CARD & Document No. :- 668573535828

Applicant Signature