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Dealership Application

General Information
Name of Company (in full) :
Business Address:
   
Business Tel No: Business Fax No:
   
Company/Business Registration No:
   
Date Incorporated: Year(s) in business:
   
Form of Business Entity
Private Limited
Sole Proprietorship
Branch/ Representative
Public Listed
Partnership
Others
   
Nature of business:
If Ltd Co Please State:  
(a) Authorised Capital: (b) Paid-Up Capital:
 
Trade References
(a)Name: Contact No.:
Period Dealing: Credit Limit: Payment Terms :
 
(b)Name: Contact No.:
Period Dealing: Credit Limit: Payment Terms :
 
(c)Name: Contact No.:
Period Dealing: Credit Limit: Payment Terms :
 
Attachment Requirement
Please fax the following documents to us (Fax:03-8070 1833)
 
(a) For Limited Company
  (i) Form 9/13
(ii) Form 24
(iii) Form 49
(b) For Sole Proprietor/ Partnership Business
  (i) Business Registration Form (Borang D/B)
  (ii) Registration of Business (Borang A)
   
Declaration
I hereby declared that the information given herein and document attached are valid and true to the best of my knowledge.
Name: Date:
Designation: