CST Form A Page 3 of 3
Name of the Applicant in full, ___________________________________________________
Signature ______________________________________________________________________
Status in relation to the dealer
*
Here enter the name of the Chamber of Commerce, Trade Association or commercial body, of which the dealer is
member.
To be filled in if the applicant is not a company.
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*** Signature of each of the persons concerned should be obtained and attested.
$
Enter here English, Bengali, Fasli, Hijra, Marwari or other calendar followed.
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In filling up these entries dealers who do not observe the English calendar should give the dates according to
their own calendar and the corresponding date of the English calendar.