Vendor Registration Form

VENDOR REGISTRATION FORM

Thank you for your interest in becoming a vendor/supplier for us.

Select Your Company (Legal Name)

Trading Name

Type of Business Entity

Nature of Business

Year Established

Proprietor/Partners/Shareholders

Registered Office Address

Purchasing Contact Name

Designation

Phone

Account Payable Contact Name

Designation

Phone

References / Previous Clients

Bank Account Number

Select Bank

Trade License

Tax Certificate

Company Profile

Declaration: I hereby declare that the information provided is true and correct.

Authorized Signatory ID

Authorized Signatory Designation

Signature Date

Signature

Company Stamp