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Service Request Form

Kindly furnish the following details along with the services desired from SSL. We shall contact you in due course.

Customer Category
 Farmers 
 Exporters 
 Lender 
 Government  
 Traders 
 Processors 
 Importers 
 Overseas  
 Co-operative  
 Others 
Name of Commodity for storage *
Location for storage: *
Quantity in MT (Approximate): *
No. of Bags:
Likely Date of Deposit:
Description
Storage Period:
(Please specify minimum period for storage in Days/Months)
Value Added Services Required
 Quality Testing and Certification Services 
 Pest Management and Fumigation Services 
 Logistics and transportation 
 Demat Warehouse Receipt 
 Warehouse Receipt Financing 
Other Services (Please specify if any):
Contact Details
Name of Company/Person:
*
Address 1:
Address 2:
City:
Postal Code:
State:
Tel. No. [With STD Code]: *
Mobile No: * *
Fax No:
Email Address: *
Name of company representative
nominated for the purpose of communication:
Representative Tel. No. [With STD Code]: