ruca®

Basic Information :

Title:

Name of the Distributor:

Permanent Address:

Town:

City:

State:

Phone No:

Mobile No:

Fax No:

Details of Immovable Properties:(Owned by Distributors)

How long have you been operating*

Number of Branches (if any)

PAN card no:

Note: Supports only pdf files.

Constitution of Distributor :

Proprietorship/ partnership/ private/Limited Co/Public Limited Co/Others (Please specify)

GST number:

GST Certificate:

Note: Supports only pdf files.

Details of Proprietors/Partners/Directors:

Name	Address& Telephone No	Residence Address& telephone No	Qualification

Manpower :

Administrative Staff:

Sales Staff:

Delivery Boys:

Details of Technical Staff:

Products being handled currently (please attach additional sheet, if required)

Name Of The Company	Status	Area Covered	Product	Approx. Turnover (In Lakhs)

Trading History:

How long have you been in FMCG products?

If yes, kindly state the product(s)

Current Distribution details:

Monthly Turnover:

Qty sold in last year:

Sales Turnover (last 3 yrs):

Name:

Address& Telephone No:

Residence Address& telephone No:

Name:

Address& Telephone No:

Residence Address& telephone No:

Name:

Address& Telephone No:

Residence Address& telephone No:

Infrastructure & Logistics

Office Space in Sq. ft:

Godown Space in Sq. ft:

No of Vehicles:

Location of the office:

Phone:

Mobile

Email:

Other modes of delivery:

Goods

You are interested in Distributorship/Dealership for:

Territory

Name of Town/ Districts for which Dealership/Distributorship is applied:

Investment

How much investment are you prepared to make for our products?

Distributor Form

Basic Information :

Constitution of Distributor :

Manpower :

Trading History:

Infrastructure & Logistics

Goods

Territory

Investment