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Customer Registration Form/ Application for Credit.

(To be completed by customer and submitted to AL RAFEE International


Mechelec ENTERPRISES WLL.) WLL.)
Trading
(Please fill by block capital letters.)

Company Registered Name.

Address. P.O. Box No.

City. Country.

Tel Nos. Fax No.

email

Commercial Reg. No. Expiry Date:

TAX Card No. Expiry Date:

Financial Information.

Paid up Share Capital. Annual Turnover.

Business Activities.

Details of Sponsor.

Name

email Contact No.

Details of Proprietors / Partners.

Name

% of Share Contact No.

Name

% of Share Contact No.

Page No 1. Out of 3
Details of Group Companies or Subsidiaries .
1. Name Business Activity

2. Name Business Activity

3. Name Business Activity

Person(s) Authorised to sign LPO and make other commitments on behalf of the company .

Name Designation

email Sign. _____________________

Name Designation

email Sign. _____________________

Contact Person(s) for Payment.

Name Designation

email Contact No.

Name Designation

email Contact No.


Bank Information .
Bank Name.

Name on Account

Account No

Please provide copy of the following document's.

Commercial Registration
Computer Card
Tax Card
ID of the Authorized Person as per Commercial Registration
Audited Financial Statement

Page No 2. Out of 3
Request for Credit (Subject to Approval).

Credit Limit Credit Period

Mode of Payment

Declaration:-
Trade Reference : (Please furnish full Name,Address & Telephone Numbers)
1. IT IS AGREED THAT PENALTY @5% PER MONTH WILL BE PAYABLE ON INVOICE VALUE, IF NOT
NamesSETTLED
of currentWITHIN
supplier,
THE APPROVED CREDIT PERIOD.
2. WE HEREBY AGREE TO OBSERVE AND ADHERE TO ALL THE CONDITIONS OF SALES GIVEN BY YOU,
1)______________ Cont Number :_________________Cont. Person : ____________________
AND TO MAKE PAYMENT WITHIN THE CREDIT LIMIT APPROVED TO US.
3. THE INFORMATION
2)______________ GIVEN:_________________Cont.
Cont Number ABOVE IS TRUE TO THE BEST OF MY: ____________________
Person BELIEF AND UNDERSTANDING AND
I/WE REQUEST YOU TO PROCESS THIS APPLICATION.
4. AL RAFEE ENTERPRISES
3)______________ WLL.
Cont Number HAS RIGHT TO TERMINATE
:_________________Cont. THE CREDIT
Person FACILITY AT ANY TIME
: ____________________
WITHOUT ANY PRIOR NOTICE
We confirm that we
5. ONCE are directly
GOODS SOLD,responsible
WILL NOT BEto TAKEN
pay "Mechelec"
BACK. dues on or before due date from our
sources and declare that the information given by us is true and correctour text

Signature of the Authorized Person (As per Commercial Registration)

Name:

Designation:

Date
Official Seal of the Firm

FOR INTERNAL USE ONLY


Remarks

Credit Approved Day's

PDC/ LC Approved Date

Business Manager Sign

Print Form
Page No 3. Out of 3