Afritank Dealer/Stockiest/Customer Account Opening Application Form

Account Opening Application Form
Please provide all required details below to qualify your business with us. If your company qualifies to become a Customer, Kentainers Ltd representative will be in contact with you to discuss further opportunities. Thank you for your interest in t Kentainers Ltd Products.
Business Owner*

First NameLast Name
Business Name*
Contact Number*

Area CodePhone Number
E-mail*
Company Website*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Type/Nature of Business*
How long have you been in business?*
Please list the products that you service/sell.*
Please provide a short description about your company.*
How did you hear about afritank Ltd?*
If Other , please specify here:*
Please describe your current interest level in becoming our Customer.*

Looking to start selling in in the next 3 monthsLooking to start in 6 monthsLooking to start in 12 monthsCurrently just researching for dealer opportunitiesReady to buy today
Which of our products are you interested in? *
What is your Annual Turnover?*
Financial manager Email
example@example.com
Procurement Manager:*

First NameLast Name
Procurement Manager Email:*
example@example.com
Procurement Manager Mobile Number:*

Area CodePhone Number
Financial Manager/Controller *

First NameLast Name
Financial Manager Phone Number*

Area CodePhone Number
Name the List of Directors/Shareholders/Partners of your company*
Name 3 Prominent Supplies you currently have Credit Accounts With?*
TIN Copy:*

Browse Files

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Incorporation/Registration Certificate Copy:*

Browse Files

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Government Valid Business Permit :*

Browse Files

Cancelof
What are your sales goals/Target if you become our Stockiest/Dealer?*
Your Bank Names/Branch/Ac Number
Sales Staff that Visited Your Premise:
Full Names
TERMS & CONDITIONS:

a) In case of any change in the constitution of the company, i.e. shareholding pattern, partners’ retirement, admission, etc. will be communicated to Afritank Ltd. with the relevant documents.

b) Afritank Ltd. may contact bankers and other suppliers of the applicant company for reference and for any information. The applicant hereby agrees that he does not have any objection to it.

DECLARATION:

You agree,Declare and submit that all the information provided herein are true and correct to the best of my/our knowledge and belief and also agree to abide by the terms and conditions Afritank Ltd.
Authorizing Signature Specimen

Clear
Date

MonthDayYear
Date
Please verify that you are human*
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