Franchisee Application Form

Section -A - Personal Information

1. Personal Details
(All Fields are required)

Full Name ( applicant 1)

Full Name ( applicant 2)

Full Name ( applicant 3)

Permanent Address of applicant Number

1

Address for correspondence

Pin /Postal Code

Telephone with STD Code

Mobile Number

Mobile Number

Fax

Email Address 1

Email address 2

Nationality

Date of Birth of applicant number 1

Educational Qualification of applicant 1

Marital Status

Name and address of reference 1

Amazon prime express pvt ltd- Mumbai

Name and address of reference 1

2. Business Experience
2.1 Do you have any previous experience in the Courier and logistics industry? If yes, please
describe (Name of company)

2.2 Do you own a Franchisee of any other company?

______________________________________________________________________________________

2.3 Will this agency be owned and operated by you?

2.4 Have you ever been self-employed? If yes - please describe:

Section B - Business Organization

Available infrastructure

Office area in Square feet

Number of computers, Printers, Bar Code

Scanner and Photo Scanner

Telephone and Internet Broadband Connection

Number of staffs

Number of vehicles for deliveries / office

purpose

Nos of CCTV Camera with DVR

Amazon prime express pvt ltd- Mumbai

3. Management
3.1 Indicate name of existing or proposed Director(s) /partners the operating company and
their previous commercial experience.

Name Position Commercial Experience

3.2 Does the operating company or do you have a person at your disposal that is in a position
to assume responsibility for the day-to-day management of the business?

Section C Commercials & documents

4. Security Deposit & Software Charges
4.1 How much capital you can invest for the Franchisee of AMAZON PRIME EXPRESS PVT LTD?

4.2 Have you gone through the Terms and Conditions mentioned above and willing to accept
the commercial terms and conditions to join AMAZON - PRIME EXPRESS PVT LTD as a
Franchisee?

5. Documents (self-attested) attached with application form:

a) Partnership Deed in case of Partnership Firm.

b) Certificate of Incorporation and Memorandum of Association & Articles of Association
c) Shop and Establishment License
d) Address proof of Proprietor / Partners / Directors ( other than ration card )
e) Service Tax Registration Number/Certificate ST2
f) Photocopy of PAN Card duly self-attested
g) Photocopy of Adhar Card duly self-attested.
h) Towards Security Deposit and Joining/Software Charges.
i) List of serviceable Pin Codes.
j) Photographs (2 nos) of Proprietor/Partners/Directors
k) Photographs of office one each from outside and inside.

6. Agreement
I hereby declare that, to the best of my knowledge and belief, the above statement and
particulars mentioned in this application form are true and complete. I also authorize you to make

Amazon prime express pvt ltd- Mumbai

any enquiries you consider necessary in connection with this application. I am aware that should
this application be refused, no reason need to be given.

I understand that any misrepresentation of factual information requested on this application form
may be a cause for termination of Business Associate of AMAZON - PRIME EXPRESS PVT LTD.

________________________________________ ________

Applicants Signature Date

________________________________________ ________

Co-Applicants Signature Date

Amazon prime express pvt ltd- Mumbai