Home » Order Form

Order Form

* Required fields

 
Dealer Name & Address
Tin/CST No.
SNo. Item Name Catalogue No. Model No. Quantity Price(each)
1.
2.
3.
4.
5.
Packing (if required) Wooden Cardboard
Excise Duty To Be Charged Extra
Exempted against Excise Duty Exemption Certificate
CST/VAT CST @2% against 'C' Form
CST @ 12.5%
VAT @12.5%
Any Other   (Please Specify)
Despatch Destination
Mode of Transportation
(Please specify transport details)
Road Permit Required
Yes   No  (if required please enter form no.)  
Any Octorio Applicable
Intallation Required
Consingnee Address
Payment Details
Your Email Adress *