UTPL TECHNOLOGIES PVT LTD
Innovations to Empower
REGISTRATION FORM FOR PRIME MEMBERSHIP
| CATEGORY | DEALER | DISTRIBUTOR |
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| VENDOR CODE (TO BE FILLED BY UTPL) | ||
| ORGATION NAME | ||
| CONTACT PERSON | ||
| ADDRESS 1 | ||
| ADDRESS 2 | ||
| CITY | ||
| STATE | ||
| ZIP CODE | ||
| COUNTRY | ||
| PHONE NO. | ||
| MOBLIE NO. | ||
| BIRTHDAY | ||
| ANNIVERSARY DATE | ||
| GST NO. | ||
| PAN NO. | ||
| AADHAAR NO. | ||
| SIGN / STAMP UTPL |
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| SIGN / STAMP UTPL |
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Corporate Office : 2nd Floor, LKS Complex, BBMP No. 309, 10th Main, 1 Block, Kalyan Nagar, HRBR Layout, Bengaluru, Karnataka - 560043
Registered Office : L-144, Gulshan Vivante, Sector-137, Noida, Uttar Pradesh - 201304
Ph: +91 9663575671 | +91 9019421946 Email: sales@utpitech.com, Web: www.utpltech.com