Annexure E - JA04: VENDOR INFORMATION FORM - Jet Airways

Annexure E - JA04: VENDOR INFORMATION FORMPlease complete this form and return it to Jet Airways (India) Ltd. You may add additionalsheets, if required.1 Registered Name of the Company:2 Address:Email Address:Telephone No.:Fax:3 Name of Contact Person:Telephone No. / Cell No.:Fax:Email Address:4 Company Registration No. (provide copy of registration certificate):Registration Date:Place of Registration:5 Company Type (Please Tick)Private ( ) Public ( ) Sole Proprietor ( ) Partnership ( ) SSI ( )Others (Please specify) _____________________________________6 Business Type (Please Tick)Manufacturer ( ) Service Provider ( ) Dealer / Distributorship ( )Trading House ( ) Others (Please specify) ____________________________________7 Turnover details:Turnover for the past three years:8 Particulars of Directors / Partners / ProprietorNameDesignation9 Products / Services proposed to be supplied to Jet Airways (I) Ltd10 Business DetailsMajor Contracts awarded /executed in past one yearName and Address ofClientTotal ValueOf ContractPeriod ofContractPage 1 of 2

11 Details of Company’s relationship with Directors or Management of Jet Airways (India) Limited(if any).12 Goods and Service Tax (GST) Registration Number:(kindly attach a copy)(not applicable to Indian Vendors)13 Bank Account Details for wire transfer of Payments:Applicable to Indian Vendors only14 Status of Company under Micro, Small and Medium Enterprises Development Act, 2006:15 Statutory Information (if yes, kindly attach copy of the certificates)ABCDEFGHICentral Excise Registration Yes NoNumberValidityService Tax Registration Yes NoNumberValidityCentral Sales Tax Yes NoNumberValidityVAT Yes NoNumberValidityPAN Yes NoNumberWorks Contract Tax Regn Yes NoNumberValidityLocal Sales Tax Number Yes NoNumberValidityESIC Regn No. Yes NoNumberValidityPF Regn No. Yes NoNumberValidityI certify that the information given is true.Signature: _______________________ Company Stamp: _______________________Designation: _______________________ Date: ______________________Page 2 of 2