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E-Business Registration Form

1. General Information*

Company/Establishment's Name (in full) :

Commercial Registration No. :

2. Primary Bank Account Details (as attachment please send a scanned copy of the bank letter)*

Bank Name: Bank Branch / Address :

Account Number: Currency:

IBAN** : Swift*** :

** - mandatory field for Kuwait companies


*** - mandatory field for overseas companies

3. Address Information*

Country : City : Street :

P.O. Box : Telephone : Fax :

Email : Web Site :


Address Type (HQ, Main Office overseas/ Workshop/ Showroom) :

4. Company Primary Contact*

Name : Position :

Telephone : Fax : Email :

5. Company Primary Contact (contact will have an admin role in eBusiness Portal for the specified company)*

User ID : Email :
First Name : Last Name:
Contact Phone :
6. - ”
* - mandatory data

Signature Stamp Date

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