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Company Name (Legal Name as per GST document) (Required)

Company PAN Card Number (Required)

Company GST Number (Required)

FSSAI License No (Required)

(“NA” if not available and apply for license on https://foscos.fssai.gov.in/ as this would be mandatory for onboarding)

Address (Required)

City (Required)

State/ Province (Required)

ZIP/Pin code (Required)

Contact person’s Name (Required)

Phone Number (Required)

E-mail address (Required)

Alternate Mobile No/Email ID

How do you categorize your type of operation?

Fleet owner

Aggregator

Aggregator with own fleet

Which areas do you operate in? (select all applicable)

National

Inter-City

Intra-city

Which corridors/lanes/routes are you currently operating in?

Which type of vehicles are available with you? (select all applicable)

Open body trucks

Closed body trucks

Temperature controlled trucks

How many vehicles & equipment sizes are available with you? (specify quantity against each equipment size; eg - 32FT(SXL) - 20. 24FT- 10) (Required)

Which fuel type vehicles are available with you? (select all applicable)

Diesel

CNG

How will you categorize your fleet type? (select all applicable)

SXL

MXL

Tractor-trailer

Which industries do you operate in? (select all applicable)

E-commerce

Pharma

FMCG

Whitegoods

Automotive

Does any company key personnel (shareholders/ directors/ Management) hold a official government position or do they have any close family member or business relationship with a Government Official?

Yes

Does any family member of the Key Personnel work in Amazon Seller Services Private Limited or any of its affiliates?

Yes

If yes , please state Employee name/Department/Location/relation (Required)

I confirm that I am physically present at the above-mentioned address on a regular basis (This address will be used for Background verification)

Yes

I hereby confirm that information provided herein is true and complete to best of my knowledge and authorize Amazon to conduct the Due Diligence Processes (“Due Diligence”), through external advisors (“Advisors”):