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

Become An Authorised Dealer

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 PAN Card Number*

Bank Account Details

Bank 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, JPEG, PNG | One file only

Owner Photo* Max size: 2MB | Allowed: JPG, JPEG, PNG | One file only

Attach Shop Documents

Shop Act License* Max size: 3MB | Allowed: PDF, JPG, JPEG, PNG | One file only

GST Registration Certificate* Max size: 3MB | Allowed: PDF, JPG, JPEG, PNG | One file only

Shop PAN Card* Max size: 2MB | Allowed: PDF, JPG, JPEG, PNG | One file only

Attach Owner's Documents

PAN Card Copy* Max size: 2MB | Allowed: PDF, JPG, JPEG, PNG | One file only

Passport Copy (Front Page) Max size: 2MB | Allowed: PDF, JPG, JPEG, PNG | One file only

Passport Copy (Back Page) Max size: 2MB | Allowed: PDF, JPG, JPEG, PNG | One file only

Aadhar Card Copy* Max size: 3MB | Allowed: PDF, JPG, JPEG, PNG | One file only

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