Name of Company Seeking Registration :  
  Work description/Package for which registration is sought:  
Date of Incorporation/Establishment :  
Registered Office Address :  
  State   District  
  STD Code   Phone No.  
FAX No.  
Web Site :
  Contact Persons Name:    
  Mobile No. :    
  Mail ID:    
  Bank Details :    
Name of Bank  
  Name of Bank Branch    
  Account No.    
  IFSC code    
  MICR code    
  (Please attach Certificate of Incorporation)  
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