Genesis Rice Inquiry Form

• Full Name      
                     First                   Middle         Surname
• Home Address
  City        Zip Code
  State      Country
  Tel. No.
  
  
• Organization Name
  Properietorship Firm Corporation
  Cert. of Inc. No. (in case of a corporation):
  Address (Registered Office)
  City        Zip Code
  State      Country
  Tel. No.
  Type of Business
  Fax
  E-mail
  E-mail Confirmation
  Url
  Your Title
  Years with the Organization
  
  
• Type of the Account :
  Company Account Personal Account
  
  
• Name of the Bank
  
  Name of the Bank Officer
  
  Bank Telephone / Fax
  
  Bank Address
  
  Bank E-mail
  
  Trade Reference 1
  
  Trade Reference 2
  
  
  
• Type of Rice Indian Basmati - polished (white) Indian Basmati -unpolished dehusked(brown) Indian Rice - Long Grain Long Grain /Milled Medium Grain /Milled Short Grain /Milled Others ( Pls Specify )
  Others ( Pls Specify )
• Detailed Specification of Rice
  

  Purity	% max
  Length of Grain	mm average
  Foreign Matter	% max
  Broken Content	% max
  Red Grains	% max
  Damaged / Chalky / Discoloured and Green Immature Grains	% max
  Moisture	% max
  Ad-mixture	% max

• Packing
• Unloading Rate Expectation CNF:
• Loading Rate Expectation FOB:
• Shipment required at :
  Port Country
• Price Basis : C & F FOB others     Other :
• Comments / Details