Bharat Petroleum Dealership Application Form


Area at ___________________Rev. District.___________________ State_______________

Classification _________ (OP/ OP-W/ SC/SC-W/ ST/ ST-W/ PH/ PH-W/ PMP/ PMP-W/ DC/ DC-W/ FF/ FF-W/ OSP/ OSP-W): (Please join duplicate of authentications as evidence from the separate equipped powers).

Promoted on _____________in ________________ by___________________

1. Singular: (Individuals & accomplices of the organization firm to encase Affidavit according to Appendix 'A')

(a) Name (in Block Letters) Ms____________________________________

(b) Father Name: ______________________________________

(c) Home Address: _______________________________________________

PIN: ___________ Cell No. ______________E-Mail ID: ___________________

(d) Gender: ______________ (Male/Female)

(e) Date of Birth: Day _____ Month ______ Year _________

(f) Qualification: _________________ (Proof to be connected)

(g) Resident of ______________District __________State ____________

(h) Nationality: ___________________

(i) Married/Unmarried: ____________________

(j) If there should arises an occurrence of unmarried lady over 40 years old: Are your folks (Mother/ Father) acquiring? YES/NO

(On the off chance that NO) I am intrigued/ not keen on profiting Corpus Fund Scheme offices (Please tick as pertinent)

(k) If there should arise an occurrence of dowagers, please join passing authentication of your spouse & additionally oath that you are not remarried.

(l) I am intrigued/ not keen on profiting Corpus Fund Scheme offices (Please tick as material)

(m) Married Women candidate with change of name after marriage ought to submit a duplicate of the marriage authentication or an

2. Are you or any of the parts of the "Family Unit" is merchant or LOI holder of any MS-HSD/ SKO-LDO dealership or LPG

Having distributorship of any oil organization? YES/ NO

If there should arise an occurrence of wedded candidate, the Family Unit implies Self, Spouse, Unmarried children and Unmarried girls.

In the event of unmarried candidate the Family Unit implies Self, Father/Mother, Unmarried brother(s) and Unmarried sister(s).

In the event of dowager candidate who has not re-hitched, the Family Unit implies Self, Unmarried children and Unmarried little girls.

3. Horrible Income amid last money related year finished 31.03. _______________ (Attach evidence)

4. Present occupation: _____________________________________________

5. In the event that you are an Income Tax Assessed, please outfit PAN NO:


6. Do you have business/ offering background? On the off chance that yes, give full points of interest: _______________________________________________________

7. Do you have experience of supervision of faculty? In the event that yes, give full points of interest. __________________________________________________

8. If you don't mind connect a different sheet giving your itemized arrangements to run the dealership, if apportioned.

9. If there should arise an occurrence of association, please give name of each of the accomplices and connect Registered/ Proposed Partnership Deed.

Application of every last one of partner(s) ought to be grouped together while accommodation: _________________________________________________________

10. Non Individual Entity Applicants like Registered Co-operation. Society/ Organized body/ Corporate House/Fleet Operator/Charitable_____________________________________________________

11. Area subtle elements (to be given by all candidates who are obliged to offer land):

(a) Do you have a suitable site promptly accessible at the area where the dealership has been promoted? YES/NO

On the off chance that Yes, Please give points of interest of area: City/Town/Village____________District_____________State:___________ Survey

No: _________ Name of the Road: ________________NH No/SH No/other _______

Street: ___________Nearest Km Stones: ___________ Total area region: (Acre/Sq.m) _________

(b) Name of the owner(s) of the area: _________________________________________________ (proof to be connected)

(c) Relationship of area holder with the candidate: _______________________

(d) Are you ready to exchange arrive discounted/long rent to Oil Company? YES/NO

(In the event that the candidate is not the area holder, assent letter/ Affidavit/ POA alongside duplicates of title records from the Land holder to be encased)

12. Give points of interest of wellspring of trusts: (to be given by all candidates aside from those requesting areas held for SC/ST class and War Widows) The type* of store ought to cover free & unrestricted Bank accounts/ Govt. Securities/ altered stores, financiers/ monetary foundation endorsement for credit value (in the encased Appendix A2), Shares of recorded open constrained organizations (with valuation report) and so on., points of interest of different resources (with valuation report) like enduring property (area, building and so forth.)/ Portable resources like vehicle and so on…, whatever other wellsprings of wage from investment, agrarian salary, rent, business and so forth (please connect verification in all cases). The subtle elements under "Account" may be given in the accompanying organization.