Hans Free Electric Dealership Request Form (India)

* indicates fields that are mandatory.
Title*

First Name*

Last Name*

Company Name*

Address*

State*

Mobile*

Phone

Nature of Business*

Please mention the brand/products for which you are dealers/distributors (if any).*

Interest in Dealership for which Districts/State?*

Area of Business* (Kindly select which areas you operate in)

RuralUrbanBoth

Ownership Structure*
Public CompanyPrivate Limited CompanyProprietorshipPartnershipOthers

Is your company registered?
Not ApplicableNoYes

Enter TIN number *

Enter PAN CARD number for Company/Individual as applicable*

Employee Strength*

Sales Staff*

Service Staff*

Annual Turnover*

INR 10 - 25 LakhsINR 25 - 50 LakhsGreater than INR 50 LakhsOther

Do you have a Warehouse?*
YesNo

Do you have a Showroom?*
YesNo

Minimum Order Value*
INR 5 - 10 LakhsINR 10 - 15 LakhsINR 15 Lakhs and above

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