Vapi Green Enviro Limited

KYC Form

Membership No.

Company Name.

Company Address.

KYC Status

KYC Status Attachment

Phase

Landline No

Landline No 2

Fax No

Proprieter/Partner/Director

Mobile No

Email Id

Proprieter/Partner/Director 2

Mobile No 2

Email Id 2

GPCB Concent No

GPCB Concent Attachment

GPCB Expiry Date

Water Connection Number

GST No

GST No Attachment

Discharge Volume

Type

Industrial Discharge Volume Domestic Discharge Volume

Pumping Station Number

Type Of Company

Member Status

Type

SSI/Non SSI Attachment

Website

Type

ROC Non ROC ROC 1

Sr No.	Person Name	Mobile No	Email Id	Designation	action
1 IsAuthorised	*	*	*

Authorised Persons Attachment

Username

Password