Plot No:- Z-103 / A, Dahej Sez Part - II, Dis. Bharuch, Gujarat - 392 130.
Tel : 02641-27 5500
Date: 01 OCT 2024 Format No.: APL/DHJ/PLANT/17-18
VENDOR DETAILS FORM
Name of the Vendor : VITIZEN HOTELS LTD
Address ( Head Office ) with Town, Town & Country: 302, JAI ANTAROKSH MAKWANA ROAD, MAROL ANDHERI EA
95/2, GANGA MATA ROAD, DEVKA BEACH, DAMAN-396210
Factory Name & Address : (Multiple ) 1 .
Factory Name & Address : (Multiple ) 2
Proprietorship /Partnership Firm / LLP / Public Ltd Co. /
Type Of Constitution ( Tick Whichever Is Applicable ) Private Ltd Co. / Foreign Co. / Trust / HUF / Association of
Person / Body of Individuals / Bank / Co-op Society
CONTACT DETAILS
Name of The Contact Person : MR. S.K. FAYAJ
E-mail Address : [email protected]
Telephone No:
Fax No :
Mobile Number & email ID of person handling VAT/CST matters: 7069757727
STATUTORY DETAILS Registered? Registration No
PAN No. ( Kindly attach copy) : Yes / No AADCI9122M
Excise Registration No. ( For All Dispatching Location ) ( Kindly attach
copy) Yes / No
Certificate of Company Registered Under Micro,Small and Medium Yes / No
Enterprises Development Act -2006 ( Kindly attach copy) : UDYAM-MH-19-0009983
VAT TIN No. ( For All Dispatching Location ) ( Kindly attach copy) : Yes / No 25000010626
CST TIN No ( For All Dispatching Location ) ( Kindly attach copy) Yes / No
GST TIN No.( For All Dispatching Location ) ( Kindly attach copy) : Yes / No
26AADCI9122M1ZB
WCT Registration Details ( For All Dispatching Location) ( Kindly attach
copy) Yes / No
Service Tax Registration No ( Kindly attach copy) Yes / No
Service Categories
ESIC Registration No. ( Kindly attach copy) Yes / No
BANK DETAILS (Attached Original Cancelled Cheque)
Name The Bank : HDFC BANK LTD
Address Of The Bank : UNIT NO.1 TOWN CENTER ANDHERI KURLA ROAD ANDHERI
EAST MUMBAI
Account No. : 59239987573808
MICR Code For The Branch :
IFSC Code for RTGS/NEFT HDFC0000592
SWIFT Code (If applicable)
Declaration: All the above details are true and changes in future will be intimated to Ajanta Pharma immediately.
Signature
Director / Authorised Person of Vendor with stamp
NOTE :-
1) All the fields are mandatory. No fields should be kept blank. Mention "N.A." wherever not applicable.
2) If dispatches are more than one location then please provide VAT TIN No., CST TIN No., E.C.C. No. seperatly.
3) SSI Registration Certificate if small scale industry.
4) All The details here mentioned should be true & if changed near future will be informed by Vendor.
