AMC Reg. No Registration Class Validity upto Full Name (Owner) Full Name (Company) Present Address City Party Code (for Office Use Only) AHMEDABAD MUNICIPAL CORPORATION Party / Contractor / Service Provider's Enrollment Form State Permenant Address City State Telephone (O) + 9 1 - - Mobile + 9 1 - eMail ID - 1 eMail ID - 2 PAN No. TIN No. Individual Partnership HUF Firm Others (Pls. Specify) CompanyType of Company (Tick Wherever Applicable) Telephone No.STD - CODE PEC NO. PRC NO. P.F. Reg. No E.S.I No Bank Account Detail MICR No. FOR OFFICE USE ONLY ENTERED BY VARIFY BY AUTHORISED BY EMP. NO DATE SIGN OF EMPLOYEE DEPARTMENT Name & Signature of Applicant With Seal Bank Name & BRANCH NEFT/RTGS NOA/C TYPE Account No. IMPORTANT INSTRUCTION 1 2 3 4 5 6 Pls. Provide Bank Account's Pass Book/Statement Copy and Cancelled Cheque Copy Please provide PAN NO Copy Form to be filled in BLOCK LETTERS ONLY. Please provide E.S.I NO & P.F.NO COPY IF APPICABLE Please provide Documents Related to Type of Company For more information e-mail us at [email protected] OR contact Zonal /Head Office of AMC ALL DATES SHOULD BE IN "DDMMYY" FORMAT