Distributor

Name *

First

Last

Email *

Mobile Number *

Enter your mobile number for user registration

Create Username *

Create your company "username" e.g "corechamp"

Create Password *

Password

Confirm Password

Create your "password" for login to core champ website

Company Detail for GEM Re-seller Agreement

Kindly fill your organization details very carefully. Company's detail is required to registration on GEM if not registered before and required for re-seller agreement.

Company Name *

Please enter your business organization name.

Company Type *

Company's Registration Date *

Kindly add your company's start/registration date

Industry/Business Domain *

For Example- Educational, Information Technology, Electronics Hardware

Company's PAN Number *

Please enter company's PAN number for PLC or LLP or Personal PAN Card for Proprietorship

Upload Company PAN *

Click or drag a file to this area to upload.

Kindly Attach Company's PAN CARD in pdf format only

GST Number *

Please enter Company's GST Number

Upload GST Certificate *

Click or drag a file to this area to upload.

Kindly Attach Company's GST Certificate in pdf format only

MSME Number

Please enter Company's MSME Udyog Aadhaar Number

Upload MSME certificate

Click or drag a file to this area to upload.

Kindly Attach Company's MSME Certificate in pdf format only

GEM Seller ID *

Kindy copy your GEM Seller Id from your GEM Seller Panel

Preferred State for Distributorship *

Select one particular state where you want to focus and sell ATL Products

Estimated Turnover *

Please enter estimated turnover till last financial year, if it is 0, kindly enter 0 only

Company Website Address

Kindly enter company's website url if any

Company official Email ID *

Kindly enter company's official email address

Company's Official Telephone/Mobile Numbers *

Kindly enter company's official Telephone/Mobile Number

Company's Logo

Click or drag a file to this area to upload.

Please attach PNG/JPEG/PDF Logo of company. File/Image shouldn't be more then 10 MB.

Company's Registered/Billing Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Kindly enter address on which company is actual registered. it must be matched with your GST Registered address

Communication Address is same as Registered Address? *

Company's Communication Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Kindly enter address if communication address is different from registered/billing address

Company's Bank Detail

Please enter company's primary bank's detail

Account Beneficiary Name *

Kinldy enter name on which your account is opened in bank for example: Corechamp Technologies Private Limited

Bank Account Number *

Kindly enter company's bank account number

IFSC Code *

Kindly enter IFSC Code

Bank Name *

Kindly enter Bank Name. E.g ICICI Bank

Primary Member/Authorized Person Information

“Primary Member/Authorized Person” means an individual authorized to legally bind your company and being allowed to sign agreement and receive the Services.

Name *

First

Last

Full Name of Primary Member/Authorized Person

Email *

Email ID of Primary Member/Authorized Person

Date of Birth *

Date of Birth of Primary Member/Authorized Person

Aadhaar Number *

Aadhaar number of Primary Member/Authorized Person

Mobile number linked with AADHAAR *

Mobile number of Primary Member/Authorized Person

Upload Aadhar Card *

Click or drag a file to this area to upload.

Upload Aadhar Card of Primary Member/Authorized Person

PAN Number *

Please enter PAN number as mentioned in PAN Card of Primary Member/Authorized Person

Upload PAN Card *

Click or drag a file to this area to upload.

Upload PAN Card of Primary Member/Authorized Person

Digital Signature by Primary Member/Authorized Person *

This is to assure that Primary Member/Authorized Person have filled this form

Co-ordinator Information

"Coordinator Means” means a person authorized by Company on member list as being allowed to communicate for the execution of the services and to communicate with CORE CHAMP on the behalf of your company

Name *

First

Last

Email *

Email ID of Co-ordinator

Date of Birth *

Date of Birth of Co-ordinator

Aadhaar Number *

Aadhaar number of Co-ordinator

Mobile number linked with AADHAAR *

Mobile number of Co-ordinator

Upload Aadhar Card *

Click or drag a file to this area to upload.

Upload Aadhaar Card of Co-ordinator

PAN Number *

Please enter PAN number as mentioned in PAN Card of Co-ordinator

Upload PAN Card *

Click or drag a file to this area to upload.

Upload PAN Card of Co-ordinator

Digital Signature by Co-ordinator *

This is to assure that co-ordinator have filled this form

Terms & Conditions

GEM Authorization Terms & Condition *

I/We agree to the Membership Details, Payment, Authorization and any applicable Terms & Conditions of Services Package Addendum in this Membership Agreement.

• Incorrect Authorization details can lead to penalization by GEM.

• Product Catalogue created by OEM will be used by Authorized Reseller without any requirement of further endorsement or change of any kind (As per AIM, NITI Aayog Guidance).

• Distributor’s Prices for all four Packages (mentioned above) will be provided in separate quotation and will be revised time to time.

• As being the Authorized Re-seller of Corechamp Technologies Private Limited, if any bid is being awarded through CORE CHAMP Brand to you on GEM ,which is related to Catalogue mentioned above, you will be bound to purchase material from Corechamp Technologies Private Limited. Failing to do so can lead to legal action or un-authorization from GEM portal.

• This Agreement, including the Terms and Conditions and GEM Re-Seller Authorization Details, and any applicable Service Package Addendum, will be effective when signed by both parties. In the event of any conflict between the Terms and Conditions and the GEM Re-Seller Authorization Details, the Authorization shall prevail.

• By signing this Agreement, you represent to us that you have the proper authority to execute this Agreement on behalf of the company listed above and incur the obligations described in this Agreement on behalf of such company.

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Company Detail for GEM Re-seller Agreement

Company's Bank Detail

Primary Member/Authorized Person Information

Co-ordinator Information

Terms & Conditions

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