New Customer registration form

Business Group :
Division :
Sales Office :
Sales Type :
 
Payer Details
Name :
Address :
City :
State :
Country :
Pin Code:
Telepbone number 1 :
Telepbone number 2 :
Fax number :
E-mail :
ECC number :
Range :
Division :
Collectorate :
Excise registration :
LST number :
CST number :
PAN/GIR number :
Contact person :
Telephone Number :
Mode of despatch :
Payment term :
 
AGENT DETAILS
Name :
 
GROUP COMPANY
Name :
 
Credit master Details
Payer Limits : (Allotted (By Credit Management Cell))
L C Limit :  
B G Limit :  
P D C Limit :  
Clean limit :