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Current Supplier *
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Organization & Contact Details
Organization Name *
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PSU - Public Sector Undertaking
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Enterprise Type
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Hospitals
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Airline/Railway Canteens
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Hotel Industry
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Food Processing/Dairy Industry
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Community kitchen
LPG used in Process industry
Others
Sector *
Specify Sector *
Pincode *
State
District
Full Address (Building/Plot No., Street, Area) *
No
Yes
Existing LPG Connection?
Contact Person *
Mobile Number *
Email Address (Optional)
PAN Number
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GST Registered
GST Unregistered
GST Registration Status
GST Number
LPG Requirement Details
-- Select Pack Size --
4 KG DOM
5 KG DOM
12 KG DOM
15 KG DOM
15 KG COM
17 KG COM
19 KG COM
21 KG COM
33 KG COM
33 KG LOT
35 KG LOT
35 KG VOT
Pack Size *
No. of Cylinders (Monthly)
Total Consumption (KG)
-- Select Frequency --
One time Requirement
Weekly Requirement
Monthly Requirement
Long Term Tie-ups
Order Frequency
-- Select Fuel --
LPG
PNG
LNG
Coal
Petrol
Diesel
Electric
Kerosene
(LDO)/Furnace Oil
Current Fuel Used
Previous Buying Price (per unit)
Export Oriented Unit
MSME Registered
Start-Up India
End Use Details
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Cooking
Heating
Industrial Process
Power Generation
Others
Primary End Use *
-- Select (Optional) --
Cooking
Heating
Industrial Process
Power Generation
Others
Secondary End Use
-- Select (Optional) --
Cooking
Heating
Industrial Process
Power Generation
Others
Additional End Use
Please Specify "Other" End Use *
Supporting Documents
Supporting Document
License, GST certificate, or authorization. (PDF, JPG, PNG - Max 10MB)
Last Invoice Copy
Latest LPG purchase invoice. (PDF, JPG, PNG - Max 5MB)
Photo of Business Premises
Clear photo of your office/factory. (JPG, PNG - Max 5MB)
Photo of LPG Storage Area
Where cylinders are placed. (JPG, PNG - Max 5MB)
Document Remarks (if any)
Supply Location(s)
Specify all locations where LPG supply is required. You can add multiple locations.
Location 1 (Primary)
Pincode *
State
District
-- Select Pack Size --
4 KG DOM
5 KG DOM
12 KG DOM
15 KG DOM
15 KG COM
17 KG COM
19 KG COM
21 KG COM
33 KG COM
33 KG LOT
35 KG LOT
35 KG VOT
Pack Size *
No. of Cylinders (Monthly)
Total Consumption (KG)
Full Delivery Address *
-- Select --
Yes
No
PNG Available in Area? *
Existing PNG Connection Details (if any)
Add Another Location
Declaration
I confirm that all information and documents provided by me are true, complete, and accurate to the best of my knowledge.
I understand that submission of this application does not guarantee approval, allotment, or supply.
I agree that the application will be processed strictly in accordance with applicable laws, rules, and regulations of the Government of India.
I hereby consent to receive communication from Mahavir Gas through SMS, calls, WhatsApp or email regarding products and services.
I agree to all the above declarations *
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