Registration name (company / close corporation):
Trading as (under what name/s do you trade/conduct business):
Street address:
Postal address:
Telephone No.:
Facsimile No.:
Email address:
Section2 - DETAILS OF OWNER / DIRECTOR / PATNER / MEMBER
1. Full names
2. ID No or date of birth
3. Residential address
4. Date of appointment
Products
Monthly purchase
Stock holding
% of Business
Exhausts:
Batteries:
Towbars:
Shocks:
Tyres:
Other (Define):
Fleet owner:
Retail:
Wholesale:
Number of lifts in shop:
How long have you been established:
1. Name of suppliers
2. Telephone
3. Contact
4. Date Account opened
Name of bank:
Branch:
Account No.:
Tel No.:
