Datec Fiji - COD Application Form

VENDOR REGISTRATION FORM

Trading Name:
Legal Name:
Business Registration No.:
Business Registration Date:	Today
Type of Company:
Physical Address:
Postal Address:
Phone:
Website:
Company Directors/ Partners:	Name \| Phone \| Email (per line)
Key Office Holders (CEO, CFO, Sales & Marketing Manager, etc):	Name \| Phone \| Email ( per line)
Sales Enquiry:	Name \| Phone \| Email ( per line)
Account Enquiry:	Name \| Phone \| Email ( per line)
Warehouse & Logistic Enquiry:	Name \| Phone \| Email ( per line)
Trade Reference:	Company \| Contact Person \| Phone Number ( per line)
BANK DETAILS:
BANK NAME:
BANK ADDRESS:
ACCOUNT NAME:
ACCOUNT NUMBER:
SWIFT CODE:
CREDIT DAYS:
CREDIT LIMIT:
Attach Business Registration:
Attach Tin Letter:
	I confirm that the information provided it this form is correct and I have the authority to sign this form on behalf of the company.