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ChequeMan –
Smart & Easy Software for Cheque Printing
Channel Partner Application Form
Organization Name
*
Establishment Year
GST No.
Name of CEO
*
CEO's Mobile No.
Address
*
City / Town
*
Pin
*
State
SELECT STATE
ANDAMAN AND NICOBAR ISLANDS
ANDHRA PRADESH
ANDHRA PRADESH NEW
ARUNACHAL PRADESH
ASSAM
BIHAR
CHANDIGARH
CHHATTISGARH
DADRA & NAGAR HAVELI
DAMAN & DIU
DELHI
GOA
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU AND KASHMIR
JHARKHAND
KARNATAKA
KERALA
LAKSHADWEEP
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
MIZORAM
NAGALAND
ODISHA
PONDICHERRY
PUNJAB
RAJASTHAN
SIKKIM
TAMIL NADU
TELANGANA
TRIPURA
UTTAR PRADESH
UTTARAKHAND
WEST BENGAL
Phone
*
Email
*
Contact Person
*
Mobile No.
*
Brief Description of Organization
Core Business
Taxation Software
Accounting Software
CA/Tax Consultant
Tax/Law Books
Tax Blogger
Other Software
Others
Equipped to provide Software Demo
Yes
No
Software Products you are dealing in
Software Product you would like to deal with
*
TDSMAN
CHEQUEMAN
BOTH
Have you used any of our product
Yes
No
Area & Segment you propose to cover and how you intend to market
Proposed investment in the venture
Upto Rs. 25,000
Rs. 25,000 - Rs. 1,00,000
Above Rs. 1,00,000
How you came to know about us
Select
Referral
Brochure
Internet
News Article
Email
Phone call
Others
Verification Code
*