NMPA Customer Registration Form
Individual / Organisations
NAME OF THE ORGANISATION:
ADDRESS FOR CORRESPONDANCE :
CONTACT PERSON DETAILS
NAME :
DESIGNATION:
E-MAIL:
MOBILE NO.
TYPE OF ORGANISATION
GOVT. UNDERTAKING
PROPRIETORY
PRIVATE LIMITED
TRADER
PARTNERSHIP
PUBLIC LIMITED
AUTHORISED DEALER
DOCUMENTRY EVIDANCE FOR TYPE OF ORGANISATION.
REGISTRATION NOS. :
i) NSIC OR MSME:
NIC/MSME Certificate.
ii) GST TIN CERTIFICATE:
GSTIN Certificate.
iii) INCOME TAX PAN NO. :
Income tax PAN Card.
DEPARTMENT APPLIED FOR:
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Administration
Civil Department
Mechanical Department
Traffic Department
DESCRIPTION DETAILS:
DECLARATION
It is declare that the information furnished above is true to the best of my/our knowledge, undertake to inform NMPA at the earliest any change in the details mentioned above, hereby agree to abide by the conditions prescribed in the policy statement.
Register
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