BAN HUAT FRUITS & VEGETABLES MARKETING

No. 2, JALAN 5/10B, SPRING CREST INDUSTRIAL PARK,

68100 BATU CAVES, KUALA LUMPUR.
TEL: 03-6187 3688 (HUNTING LINE) FAX: 03-6188 6689/6185 3588
EMAIL: banhuatfruits@gmail.com WEBSITE: www.banhuatfruit.com

CREDIT APPLICATION PROPOSAL FORM

COMPANY BACKGROUND

1 NAME OF COMPANY : _____________________________________________

2 TEL NO : _____________________________________________

3 NAME OF HOTEL/CLUB/REST : _____________________________________________

4 GST NO: _____________________________________________

5 COMPANY REGISTRATION NO: _____________________________________________

6 PERSON CONTACT : _____________________________________________

7 BILING ADDRESS : _____________________________________________

8 DELIVERY ADDRESS : _____________________________________________

9 ACCOUNT TEL NO : _____________________________________________

10 ACCOUNT PERSON TO CONTACT : _____________________________________________

11 LEGAL CONSTITUTION : o SOLE PROPRIETOR

o PRIVATE LIMITED
o PARTNERSHIP
o PUBLIC LIMTED

STATUTORY INFORMATION

1 AUTHORISED CAPITAL RM _________________________________________________

2 PAID UP CAPITAL AS AT ________________________ RM _______________________

3 BUSINESS REGISTRATION NO : _____________________________________________

4 YEAR ESTABLISHED : _____________________________________________________

5 PLEASE PROVIDE FORM 49 & 24 (FOR LIMITED COMPANY ONLY) OR

BORANG A (SOLE PROPRIETOR)

6 TERMS OF PAYMENT : DAYS (FROM DATE OF INVOICE) _________________________

7 CREDIT LIMIT : RM _________________________________

8 TERMS OF PAYMENT & REASON : __________________________________________

NAME, IC & ADDRESS OF PROPRIETOR / PARTNERS / DIRECTORS
(Please attach list of proprietor / partners / directors)

1 NAME IC ADDRESS DESIGNATION

2 BANKERS : _____________________________________________

3 BANKERS ADDRESS : _____________________________________________

4 ACCOUNT NUMBER : _____________________________________________

5 PARTICULARS OF BUSINESS PREMISES :

(a) o OWN PREMISE
(b) o RENTED PREMISE
(c) o OTHER (PLEASE SPECIFY) _____________________________________________

We / I confirm that the above information are true and correct

SIGNATURE : ________________________________________________

NAME : ________________________________________________

DEPT / TILE : ________________________________________________

________________________________________________
COMPANY OFFICIAL STAMP / CHOP

FOR OFFICE USE ONLY

APPROVED CREDIT LIMIT : RM ________________________________

PROPOSED BY ( SALES REP ) : RM ____________________________