Vendor Registration Form
Vendor Registration Form
Vendor Registration Form
FORM
Date Evaluated
Registration intimated on
Rejection intimated on
General Instructions
All parts of the registration form must be completed, and all above
requirement must be fully complied with.
All parts of this registration form must be completed, incomplete forms will not be
processed (Apply only if your firm has been established for more than two (2)
Years)
Part 1 Purpose - Please tick as appropriate.
□ NEW REGISTRATION
□ CHANGE OF NAME/ADDRESS
□ ADD PRODUCT OR SERVICE CATEGORIES
□ DELETE PRODUCT OR SERVICE CATEGORIES
□ RENEWAL OF REGISTRATION
□ OTHERS, PLEASES PECIFY _________________________________
□ CORPORATION _______________________________________
□ LIMITED LIABILITY CO. _______________________________________
□ PARTNERSHIP _______________________________________
□ SOLE PROPRIETORSHIP _______________________________________
□ MANUFACTURER _______________________________________
□ OTHER ( SPECIFY ) _______________________________________
Part 3 – Certificates Validity.
S.No Certificate Certificate No Expiry
Date
1 Incorporation Certificate
DESIGNATION
OFFICE ADDRESS.
PO BOX
POSTAL CODE
CITY / TOWN
COUNTRY
TELEPHONE NO.
MOBILE NO.
FAX NO.
E-MAIL ADDRESS
YES NONE
(If Yes; then provide detail :)
1. NAME __________________ POSITION ___________
DEPARTMENT __________________RELATIONSHIP ___________
Note:
In case of audit accounts are not available; a business Profit & Loss
statement is required to be submitted on the company letter head along with
copy of Tax Return details.
DECLARATION:
confirm that the information provided herein is true, accurate and correct. I
agree that this registration, if accepted, shall be valid for 3 years from the date
PTCL. I also confirm that in the event of any changes of status or changes in
_____________________________ __________________________
Signature Date
Name :- _____________________________
Designation _____________________________
_________________________________
_________________________________
_________________________________
_________________________________
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