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Email Verification

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Email Address

Supplier Onboarding

Complete the form below to join our supplier network

Company Details

Legal Info

Banking

Documents

Business Info

Declaration

Basic Company Details

Supplier / Firm Name *

Business Type *

Registered Address *

Office / Correspondence Address

Same as Registered Address

City *

State *

Pincode *

Contact Person Name *

Designation *

Mobile Number *

WhatsApp Number

Email ID *

Website

Contact for Dispatch

Contact for Accounts

Contact for Sales

Preferred Communication Mode

Registration & Legal Information

PAN Number *

GST Number *

CIN / LLP Number

UDYAM / MSME Registration No.

FSSAI License Number

Drug License Number (Form 20B / 21B) *

Drug License Validity (Start Date)

Drug License Validity (Expiry Date)

Wholesale / Retail License

Import License Number (if any)

Banking & Payment Details

Bank Name *

Branch Name *

Account Holder Name *

Account Number *

IFSC Code *

Payment Terms *

Cancelled Cheque *

PDF, JPG, PNG (Max 10MB)

Compliance & Documentation

PAN Copy *

PDF, JPG, PNG (Max 10MB)

GST Certificate *

PDF, JPG, PNG (Max 10MB)

Drug License Copy *

PDF, JPG, PNG (Max 10MB)

FSSAI License Copy *

PDF, JPG, PNG (Max 10MB)

Authorization Letter (if applicable)

PDF, JPG, PNG (Max 10MB)

Company Profile / Product List

PDF, DOC, XLS (Max 10MB)

Business & Operational Information

Brands / Companies Represented

Average Monthly Supply Capacity

Key Products Supplied

Primary Market / Region

Existing Customers / Distributors

Declarations & Additional Information

Terms & Conditions

Supplier Agreement Terms & Conditions

1. Agreed Net Margin

The agreed net margin shall be clearly mentioned on every invoice.
Both parties shall strictly adhere to the agreed margin without deviation.
In case of any deviation or difference between the agreed and invoiced margin, Jeplus reserves the right to return the goods.

2. Payment & Credit Notes

The Supplier authorises Jeplus to adjust any pending amounts against valid credit notes if such notes are not raised within 24 hours of returns/RTV.
All credit notes must be issued promptly to avoid any payment disputes.
Jeplus will ensure timely payment as per the agreed terms for all goods accepted in line with the purchase order.

3. 100% Genuine Products

The Supplier shall supply goods only against valid invoices.
The Supplier guarantees no mismatch between invoice details and supplied products.
Products sourced from Bhagirath Place or any other indirect/unofficial channels are strictly prohibited.
However, goods procured from authorised brand distributors (e.g., if ABC Company is an authorised distributor/supplier of Cipla, goods purchased from ABC Company may be supplied to Jeplus) are permitted.

4. Supply Authenticity & Traceability

Products must be sourced only from authorised stockists, company depots, or medical representatives.
Jeplus may request complete supply chain documentation (invoices, challans, supporting proofs) at any time for audit purposes.
If the Supplier fails to provide such documentation, Jeplus may withhold or adjust payments until satisfactory proof is submitted.

5. Damage Return Terms

All damaged products shall be accepted back by the Supplier.
A credit note must be issued immediately after the damaged stock is received.

6. Slow-Moving / Dead Stock (Applicable / Not Applicable)

Jeplus may return any slow-moving or dead stock as mutually reviewed.
The Supplier shall accept such stock and issue credit notes promptly without delay.

7. Schemes

The Supplier shall extend all applicable running schemes to Jeplus.
If any discrepancy or shortfall in schemes is identified, Jeplus reserves the right to deduct the difference from payable amounts.

8. Compliance & Relationship

Both parties agree to maintain transparency, good faith, and mutual respect in all transactions.
These Terms & Conditions are binding on all transactions unless amended in writing and mutually agreed upon by both parties.

I have read, understood, and agree to abide by the Terms & Conditions of Jeplus Healthcare *

You must accept the Terms & Conditions to proceed.

I have read and agree to the Privacy Policy and consent to the processing of my personal data *

You must accept the Privacy Policy to proceed.

Declaration

We hereby declare that all information provided above is true and correct to the best of our knowledge.

Authorized Person Name *

Designation *

Date *

Company Seal / Stamp

To be affixed on printed copy

Optional Information (Recommended for Pharma)

Cold Chain Handling Capability

GST Return Filing Frequency

Credit Note & Return Policy Acceptance

Quality & Expiry Commitment Clause

Primary Warehouse Address (for pickups/returns)

Email Verification

Supplier Onboarding

Basic Company Details

Registration & Legal Information

Banking & Payment Details

Compliance & Documentation

Business & Operational Information

Declarations & Additional Information

Terms & Conditions

Supplier Agreement Terms & Conditions

1. Agreed Net Margin

2. Payment & Credit Notes

3. 100% Genuine Products

4. Supply Authenticity & Traceability

5. Damage Return Terms

6. Slow-Moving / Dead Stock (Applicable / Not Applicable)

7. Schemes

8. Compliance & Relationship

Declaration

Optional Information (Recommended for Pharma)

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