Name of the Firm
Constitution Proprietorship Partnership Pvt Ltd Others
Principal Contact Name
Registered Office Address
GST Number
FSSAI License Number
Godown/Warehouse Space (Sq Ft)
Godown Address
Three Wheelers
Four Wheelers
Sales Executives
Delivery Personnel
Years in FMCG/Tea Business
Total Retail Outlets Covered
Territory Covered
Currently Distributor for Other Brands? Yes No
If Yes, List Brands
Current Monthly Turnover (₹)
Proposed Investment for KeralaChai (₹)
Expected Monthly Sales Volume (kg) 500 – 1,000 kg 1,000 – 2,500 kg 2,500 – 5,000 kg Above 5,000 kg
Why do you want to partner with KeralaChai?
Do you have a field sales team? Yes No
Preferred Territory
Signature & Seal
Date
Submit Application
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