Consumer Registration

Application Number :- 4125343233
Date :- 18-10-2017
Financial Year

State

Unit Name *:
 
Authorized Person Name *:
 
Email *:
 
Mobile:
User ID :
 
Password :
Confirm Password :
 
Type of Unit *:
 
Category of Unit :
 


(Only Choose .jpg , .jpeg and .png profile image)

Select SNA *:
 
Location of Unit
(Full address with PIN):
Recommendation of
State/DIC Ref No :
Annual Coal Requirement (T) :
  
Please Attach Required Document : (Only PDF file Upload)
Select File Type*:
 
 
Valid SSI/Industrial Registration Certificate
No file chosen      
DECLARATION
I/We *   as the owner of the firm/partner/authorized representative(s) do here by declare that coal supply taken through State Nominated Agency will be used for own consumption and will not be diverted/resold.



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