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ERP Account - Customer Registration Form

Account Details

Full Registered Name: *

Registration Number: *

VAT Number: *

Telephone Number 1: *

Telephone Number 2:

Telefax Number:

Accounts Contact Person Name Surname: *

Accounts Accounts Email: *

Accounts Telephone Number:

Accounts Cellphone Number:

Buyer Contact Person Name Surname: *

Buyer Email: *

Nature Of Business:

Add Registered Office Address From Map

Address

Email: *

Phone number: *

Address 1: *

Address 2:

Country: *

State / province:

City: *

Zip / postal code: *

Type Of Business: *

Estimate Purchases Per Month ZAR: *

Credit Limit Required:

Physical Trading Address

FullName: *

Surname: *

Add Physical Trading Address From Map

Address

Email: *

Phone number: *

Address 1: *

Address 2:

Country: *

State / province:

City: *

Zip / postal code: *

Banking Details

Name Of Banker: *

Account Name: *

Account Number: *

Branch Code: *

Branch: *

Trade References

Name: *

Telephone: *

Amount: *

Terms: *

How Long: *

Premises

Owned Or Leased: *

Name of Landlord: *

Address Of Landlord: *

Email Of Landlord: *

Telephone Number Of Landlord: *