Send Us Your Valuable feedback



Which Product you are using?

Excellent  Good  Average  Poor 

Excellent  Good  Average  Poor 

Excellent  Good  Average  Poor 

Excellent  Good  Average  Poor 

Excellent  Good  Average  Poor 

Very Satisfied  Satisfied 
Rating:

Name: *
E-mail: *
Mobile No: *
Any Suggestions: *
 Please feel free to get in touch, we value your feedback


Organization Details
Buyer's Name
(Organization/Individuals): *		 Address: *
Location: * Landmark: *
City: * State: *
Zip Code: * Country: *
Phone1: * Phone2:
Mobile1: * Mobile2:
E-mail1: * E-mail2:

Contact Details

Contact Person
 




 
Chief/Head of the Organization      
 

License Details

Product Name: * Serial No: *
Release: * TNS Expiry Date:

Service Details

No of Systems in AMC: * Registration Type: *
Service Type: * Plan Type:
Start Date: End Date:
Total Units: * Tracking Units:

Business Details

How many locations does your customer operate from? *
Type/Entity of organisation *

Taxes applicable for the company and how returns are filed
Type Of Taxes E-filing Manual
Excise
Income Tax
Service Tax
VAT
Professional Tax
TDS
TCS

How many computers are installed in your location where Product has been activated?
How many full-time employees work at the location where Product has been activated?
The person whom you contacted in Brilliant technologies
Description / Requirement:

[Click on image to refresh]

Captcha image

Enter the code here: