Customer Registration Sheet

This form must be completed in full, and All information disclosed in this form will be kept private and Confidential.

Contact Person Information

First Name*

Last Name*

Email*

Phone*

Mobile Phone*

Fax*

Business Information

Nature of Business *

(Business Activity/Industry)

Trade License No.*

Place of Issue*

Date of Issue*

Expiry Date*

Type of ownership*

Bank details

Bank Name*

Account Name*

Branch*

Address*

Account Number [SAR]*

IBAN [SAR]*

Account Number [USD]*

IBAN [USD]*

Swift Code*

Trade References

Company*

Contact*

Phone*

Payment Terms*

Limit*

Signature

I confirm the above information is correct to the best of my knowledge. I undertake to inform you promptly if any material change in the above information

Signatory Name*

Designation*

Date*

Customer Registration Sheet

Company Information

Communication

Bill to Address

Ship to Address

Contact Person Information

Business Information

Bank details

Trade References

Signature

Name
Phone No
Email Address
Subject
Description