Vendor Registration Vendor Registration Form 59Care.Com Shop Type New Electronics Products Sales Electronics Repair Shop Enter Employee Id Business/Individual Name: Name Business Type Individual Proprietorship Partnership Private Ltd Public Ltd Registration Number (if applicable) GST Number (if applicable) Business/Residential Address: Street: Land Mark City: Pin Code: State: Andaman and Nicobar Island Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Dadra and Nagar Haveli and Daman and Diu Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Ladakh Lakshadweep Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Puducherry Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttar Pradesh Uttarakhand West Bengal Primary Contact Person: Name: Phone Number: Email: Alternate Contact Person: Name: Phone Number: Email: Bank Name: Bank of Baroda Bank of India Bank of Maharashtra Canara Bank Central Bank of India Indian Bank Indian Overseas Bank Punjab and Sind Bank Punjab National Bank State Bank of India UCO Bank Union Bank of India Axis Bank Ltd. City Union Bank Ltd. DCB Bank Ltd. Federal Bank Ltd. HDFC Bank Ltd. ICICI Bank Ltd. IDBI Bank Ltd. IDFC FIRST Bank Ltd. IndusInd Bank Ltd. Jammu and Kashmir Bank Ltd. Karnataka Bank Ltd. Karur Vysya Bank Ltd. Kotak Mahindra Bank Ltd. RBL Bank Ltd. South Indian Bank Ltd. Yes Bank Ltd. Dhanlaxmi Bank Ltd. Bandhan Bank Ltd. CSB Bank Ltd. Tamilnad Mercantile Bank Ltd. DBS Bank India Limited Branch Name: Account Number: IFSC Code: Business Registration Certificate (if applicable) PAN Card Copy GST Registration Certificate (if applicable) Bank Passbook/Cancelled Cheque Aadhar Card Raise request Request with Ease, Relax with Assurance Effortless Appliance Solutions at 59care.com Your Comfort is Our Priority Relax Knowing Your Appliances are in Expert Hands