Vendor Registration Form
S. No. Particulars Details to be Provided
1 Name of Vendor SHREE KULFI
2 PAN No BYVPS1634Q
3 Contact person SIVAKUMAR P
4 E Mail ID
[email protected] 5 Mobile No 9842210920
6 Banking Details
Account holder Name SHREE KULFI
Bank Name CANARA BANK
Branch Name SAIBABA COLONY
Account Number 1239201013202
Account Type 1. Savings [ ] 2. Current [•] 3. Others (Please Specify)
IFS Code CNRB0001239
MICR
SWIFT Code
7 Whether Registered under GST ? 1. Registered [•] / 2. Composition [ ] / 3. Unregistered [ ]
1. Below Threshold Limit []
2. Exempted service /Goods []
8 If Not Registered, reason for the same? 3. In Process of Registration []
4. Other, Pls specify -
9 Whether located in SEZ 1. Yes [ ] / 2. No [•]
10 GSTN No / Composition Registration No 33BYVPS1634Q1ZI
UIN No (In case of Government Department /
11 Authorities)
12 Address as per GST Registration for State / UT
Street/House number OLDNO361 NEWNO1138A, METTUPALAYAM ROAD, NEAR BSNL OFFICE
City COIMBATORE
State / UT TAMILNADU
PIN Code 641043
13 Whether having multiple registrations in same state? 1. Yes [ ] / 2. No [•]
- If Yes, specify business unit
Whether having separate GST Registration in other
14 1. Yes [ ] / 2. No [•]
state
/ union territory
- If Yes, provide details of the same for each GST
Registration No. in separate form
15 Mandatory Enclosures
PAN Copy
Cancelled Cheque Leaf
GST Acknowledgement copy / Certificate
I / We confirm that the information provided above is true to my knowledge and belief. I / We declare that we will file the GST
returns and pay the GST amount within the due dates as prescribed in GST laws.
SIVAKUMAR P SHREEKULFI
Date: 2 0 / 0 3 / 2 0 2 5
Place: C O I M B A T O R E (Name & Signature of Authorized Signatory) (Company Seal )