MyIndiFuels Plant Setup Application Form

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Name of the Applicant *

Father’s/ Husband’s Name: *

Applying for: *

Address *

PIN Code *

Date of Birth *

YYYY

Educational Qualification (s): *

Name of the Existing Firm(if any): *

Address of land ( For proposed pump/plant ) *

Mobile Number *

Email ID *

Nationality *

Gross Income during last financial year ended 31.03.2023 INR *

Present occupation *

In case you are an Income Tax Assesses, please furnish PAN NO: *

Do you have business / selling experience? If yes, give full details: *

UNDERTAKING:-

I undertake to produce Originals of all the attachments enclosed with this application at the time of interview, if called for and is aware that in the event I fail to produce the Originals, my application for dealership will be disqualified. I am fully aware that My Indifuels Pvt. Ltd. under its policy will not appoint me as its dealer if I am employed. I shall have to resign from the service and produce proof of acceptance of my resignation from my employer to My Indifuels Pvt. Ltd. before issuance of Letter of Appointment for the dealership.

That, if selected, I undertake that I will deposit an interest free Security deposit as mentioned in the advertisement for the subject location, as per the policy of My Indifuels Pvt. Ltd.

I, hereby certify that the information given above is true to the best of my knowledge and belief. Any wrong information / suppression of facts will disqualify me from being considered for the dealership.

Deny

Required

Place *

Date *

YYYY

Name in Block Letters *

Designation *

Submit

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