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E-Commerce Partnership Registration Form: Company Information

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Photo of the

Proprietor/ Photo of the


Managing Business
Partner/CEO/MD/ Representative
Chairman
e-Commerce Partnership Registration Form
Form Fill-up Date: _____/_____/______
Company Information
Company Name : Establishment Date: ____/____/_____

Website : Parent Company (if any):


Address :

e-Commerce Operation Duration :

Social Media : 1. 2.
Accounts’ Links
3. 4.

Association Membership: Bangladesh Computer Samity (BCS)


Bangladesh Association of Software & Information Services (BASIS)
Bangladesh Association of Call Center & Outsourcing (BACCO)
e-Commerce Association of Bangladesh (eCAB)
Other (Specify)

Business Communication Information


Person Name : Designation:

Telephone No. : Mobile No.:

E-Mail Address :

Proprietor/Managing Partner/CEO/MD/Chairman Information


Person Name : Designation:

Mobile No. : E-Mail Address:

Permanent Address :

NID No. :

Transaction Information
Monthly Expected e-Commerce Transaction : BDT
Initial Upfront Cash Transaction Duration :

Enclosures
Trade License
Tax Return Submission Receipt / eTIN Registration Certificate
VAT Certificate
NID Copy of the Proprietor/Managing Partner/CEO/MD/Chairman
Security Cheque of Amount BDT: _________ Cheque No.: ______________ Bank: ___________________

Signature of the Business Representative Signature of the Proprietor/Managing Partner/CEO/MD/Chairman

Approval Note: Approved Not Approved

Approval Date: ____/____/_____


Signature:

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