Recent pp size
Please staple two
Recent pp size
Redington
Photos of Prop
/Partners /
Photos of
Prop/Partners/
Redington (India) Limited
Directors with Directors with SPL Guindy House
name written on the name written on the
backside of the backside of the 95, Mount Road, Guindy,
photo photo Chennai – 600 032 India
Name and Residential address of the Prop. /Partners / Directors (Please attach separate sheet, if more than two)
1)____________________________ (2)__________________________
____________________________ __________________________
Phone:_________________________ Phone_______________________
Passport No:-___________________ Passport No:-_________________
Declaration:-
Mr / Ms.___________________________,the Proprietor /Partner/Director of M/s.____________________ do hereby declare
that the particulars furnished above are true and correct to the best of my Knowledge and belief. I also confirm having read,
understood and agreed to the Terms and Conditions as mentioned over leaf.
Date:
Place: Signature & Seal
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FOR INTERNAL USE ONLY:-
RIL Sales Man Code : MARCO___________ ASM_____________
Mode of Payment : DD / CDC / Credit
If credit, amount of credit recommended: _____________ (Lakhs) _______(Days)
Date:-
(Signature of the Dealer with Seal)
Place
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