Customer Registration

Submitted by admin on Sat, 03/17/2012 - 11:39

Enquiry

TO BE COMPLETED BY NEW PARTNER ONLY

General Information: *

Partnership

Sole Proprietorship

Corporation

WEB / E-mail Address:

Country of Incorporation: *

Number of Branches/Outlets: *

Registered Business Name: *

Business Address:

Nature of business:

Office Telephone:

Facsimile:

Billing Address (if different):

Shipping Address (If different) :

Name(s) of all Owners/Shareholders:

Name(s) of all Directors:

Name, title of person to contact for payment:

What will be your estimated yearly purchase from Microvillage? :

Credit line requested (in Rs.):

What credit term are you requesting? COD, 7 days, 14 days, 21 days or 30 days :

Bank Information [Primary Banker(s)] :

Bank Name:

Branch:

Name:

Credit amount provided:

Name:

Credit amount provided:

Documents/Financial statement required::

1) Your latest financial statement (Balance Sheet and Income Statement) must accompany this application if requesting for credit. If financials is unaudited, the owner/responsible officer must sign and date each financial statement.:

2) Copy of Business registration certificate showing full Company name & Names of directors and owners/shareholders. :

Declaration:

Any pending litigation against the company?:

Yes

Brief description :

Date of legal action taken :

Partner agrees to promptly inform Microvillage in writing of any changes to the information given in this Partner Application Form (especially changes in owners/shareholders, directors, and related/affiliated companies). partner agrees to make payment in :

I hereby certify that all products purchased from Microvillage Communications are for resale to end users (who purchase for internal use) in the countries as authorized by the manufacturer or publisher of the products only.:

Dated this:

Signature & Name of Director/Owner & Co Stamp :

THIS PARTNER APPLICATION FORM MUST BE SIGNED BY THE REGISTERED DIRECTOR OF THE COMPANY OR THE LEGAL OWNERS OF THE BUSINESS. THE SIGNING OF THIS APPLICTION FORM WOULD CONSTITUTE ACCEPTANCE OF THE TERMS AND CONDITIONS OF SALES, A COPY OF WHICH IS ENCLOSED. THE SALES TERMS AND CONDITIONS MAY BE AMENDED FROM TIME TO TIME AND ARE PUBLISHED ON MICROVILLAGE WEBSITE LOCATED AT WWW.MICROVILLAGEINDIA.COM
* Partner will be bound by Microvillage Sales T&Cs (for Products) if orders are for products.

Please mail the original form to:

Microvillage Communications Pvt. Ltd.,
#28, 3rd Floor, Microvillage Centre, HAL 3rd Stage,
80 Feet Road, Indiranagar,
Bangalore - 560 075.
Attn: Sales Department
Fax No: 080 - 25280359

Primary links

Customer Registration