User Registration Form

Note:Fields marked with * are Mandatory.

*PAN No.
*Name of Company
Phone Number
Fax Number
Web Site
Phone Number
*Mobile Number
* PAN No.
* PAN No.
Please provide Scanned Copies of PAN, VAT, CST documents.
Endorsement No.
Email ID.
*Confirm Password
*Security Question
*Security Answer
*Enter Captcha
Fill out the Form and Get Registered with MIDC.
Enter Your Company Information
(Select Pin Code to get Country,State and District.)
* Phone No :
(Phone number must be 11 numbers.)
Fax No :
Web Site :
Enter Your Contact Information
* Name :
Designation :
Phone No :
* Mobile No :
* Email :
* Specialization :
Enter Your General Information
* PAN NO :
(The PAN number must be Alpha numeric with 5 alpha, 4 numeric and 1 alpha character.)
*VAT No. :
(The VAT registration number must be numeric with 11 characters.)
Service Tax No. :
(Service tax number must be alphanumeric with 5 alpha, 4 numeric, and 3 alpha and 3 numeric characters.)
Endorsement No. :

Create your User Id & Password
* User ID :
6 - 20 characters (A-Z, a-z, 0-9 only, Use of special characters not allowed.)
* Password :
* Re-Enter Password :
*Security Question :
*Security Answer :
*Enter the code displayed in the image: