Dealer Form | Premier Plus - Preferred brand in the Independent Automotive Aftermarket Pune

Become An Authorised Dealer

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Dealer Application Form

Shop Details

Shop’s / Firm Full Name*

Shop Address*

City*

Pincode*

District*

State*

Mobile Number*

Landline Number

Email Address

Region

Registration Numbers

Shop Act License Number

Shop GST Number*

Shop Pancard Number*

Bank Account Details

Bank Account Name

Bank Account Number

Bank Branch

IFSC Code

Owner's Details

Shop Owner’s Full Name *

Title

Date of Birth*

Gender*

PAN Card Number*

Aadhar Card Number*

Passport Number*

Attach Photo

Shop Photo Max size: 2MB | Allowed: JPG, PNG | Only 1 file

Owner Photo Max size: 2MB | Allowed: JPG, PNG | Only 1 file

Attach Shop Documents

Shop Act License Max size: 3MB | Allowed: PDF, JPG, PNG | Only 1 file

GST Registration Certificate Max size: 3MB | Allowed: PDF, JPG, PNG | Only 1 file

PAN Card Max size: 2MB | Allowed: PDF, JPG, PNG | Only 1 file

Attach Owner's Documents

PAN Card Copy Max size: 2MB | Allowed: PDF, JPG, PNG | Only 1 file

Passport Copy (Front Page) Max size: 2MB | Allowed: PDF, JPG, PNG | Only 1 file

Passport Copy (Back Page) Max size: 2MB | Allowed: PDF, JPG, PNG | Only 1 file

Aadhar Card Copy Max size: 3MB | Allowed: PDF, JPG, PNG | Only 1 file

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