AUTOVATION SDN BHD

(Company No. 398024-X)

No. 23, Jalan Puteri 4/1, Bandar Puteri, 47100 Puchong, Selangor Darul Ehsan, Malaysia
Tel : (603) 8064 7888 Fax : (603) 8064 7999 E-mail : enquiry@autovation.com.my
APPLICATION FORM FOR CREDIT FACILITIES
(Also used for application for increase of credit limit)

A. APPLICANT
Name of
Business Name: _____________________________________________ M.D. or G.M.: __________________________________
Name of Person-inAddress: ___________________________________________________ Charge of Payment: ______________________________
Name of
___________________________________________________________ Purchasing Manager: _____________________________
Name of
___________________________________________________________ Accountant: ____________________________________
Telephone No.: ______________________________________________ Fax No.: _______________________________________

B. BUSINESS REGISTRATION INFORMATION

Please enclosed certified copy of Form 49 & 24 if private or public limited company.

Private Limited Co.

Authorised Capital: ___________________ Paid-up Capital: _____________ Partnership Public Limited Co.
Business Regn. No.: __________________ Date: _______________ Sold Proprietorship

Name of Proprietor/Partners/Directors
1. ___________________________________________
2. ___________________________________________
3. ___________________________________________

I/C No.
____________________
____________________
____________________

Residential Address
__________________________________
__________________________________
__________________________________

4. ___________________________________________

____________________

__________________________________

Name of Major Shareholders

1. ________________________________
2. ________________________________
3. ________________________________

No. of Shares
________________
________________
________________

Name of Bankers
1. ________________
2. ________________
3. ________________

Branch
____________
____________
____________

A/C No.
______________
______________
______________

C. CREDIT STANDING WITH OTHER SUPPLIERS

Supplier Name
1. _____________________________________
2. _____________________________________
3. _____________________________________

D. CREDIT FACILITIES REQUIRED

Credit Limit RM __________________
Credit Terms: __________________Days

Period Dealing
_________________
_________________
_________________

Credit Terms
_________________
_________________
_________________

Credit Limit
________________________
________________________
________________________

E. I/We hereby agree to accept the terms and conditions as printed on this Application
Form in respect of all present and future business transactions between us and certify
that all information given is true and correct.

_____________________________________________
Applicants Authorised Signature and Chop

_______________
Date

F. TERMS AND CONDITIONS

1. All payments must be made in full on due date and/or within the credit period stated in our invoice/delivery order.
2. Interest charge at 1.5%per month will be charged on the overdue invoices.
3. The company reserves the right to suspend credit or cancel the credit facilities granted without prior notice.