Username*
Email*
First Name
Last Name
Address 1*
Address 2
Country*
City/Town
State/County
Postcode/Zip*
Store Phone*
Whatsapp Number*
Company Name / Firm Name*
Attach Company's / Firm's Registration Certificate (PDF Format Only) GST NOT ALLOWED*
Select THE ORGANIC SUPERMART Fulfillment Centres*
Your Designation*
Ownership Proof / Authorization Letter (PDF Format Only)*
PAN Number*
Attach Scanned Self Attested Pan Card Copy (PDF Format Only)*
Aadhar Number / Voter ID*
Attach Scanned Self Attested Aadhar Card / Voter Card Copy (PDF Format Only)*
GST Number*
Attach GST Certificate (PDF Format Only)*
FSSAI LICENCE NUMBER (States) [For Food Brands]
FSSAI License Expiry Date
Attach FSSAI States License [For Food Brands] (PDF Format Only)
GOTS CERTIFICATE NUMBER
GOTS Certificate Expiry Date
Attach GOTS CERTIFICATE (PDF Format Only)
OCS100 CERTIFICATE NUMBER
OCS100 Certificate Expiry Date
Attach OCS100 CERTIFICATE (PDF Format Only)
COSMOS Certificate Number
COSMOS Certificate Expiry Date
Attach COSMOS Certificate Copy (PDF Format Only)
NPOP Certificate Number
NPOP Certificate Expiry Date
Attach NPOP Organic Certificate (PDF Format Only)*
NOP Certificate Number
NOP Certificate Expiry Date
Attach NOP Organic Certificate (PDF Format Only)
EU Organic Certificate Number
EU Organic Certificate Expiry Date
Attach EU Organic Certificate (PDF Format Only)
Attach OTHER CERTIFICATES / LICENCE
Brand Name / Store Name*
Trademark / Brand / Store (Logo) (png, jpg or jpeg Format Only)*
Brand / Trademark Certificate (PDF Format Only)
About Your Brand / Store*
Bank Account Name*
Bank Account Number*
Confirm Bank Account Number*
Account Type*
IFSC*
Bank Branch Name*
Bank Name*
Bank Address*
Cancelled Cheque Image (PDF Format Only)*
Password*
Confirm Password*
* Agree Terms & Conditions
