ITDistribution

Credit Application Form
Instructions: 1) This form must be completed by the company or its representative making the application. 2) To ensure that application is processed without delay, please make sure that the information provided is accurate. 3) Please enclose audited Balance Sheet and Profit and Loss Statements for the last two years, latest 3-months bank statement and Management Accounts 4) Memorandum and Articles of Association. 5) Form 24 & 49. For more information, please contact 603-2094 8766. Our Account Manager will get back to you shortly upon form submission.

Business Name:
Business Registration Number:
Date of Registration:	(mm/dd/yyyy)
Registered Address:
Registered Address:
Business Address:
Business Address:
Tel:
Fax:
Contact Person:
Designations:
Type of Business Type:	Sole Proprietor
	Partnership
	Sdn Bhd
	Berhad
	Society
	Others
Others (Please specify) :
Paid-up Capital :
Bank References (a):
Address:
Address:
Account Numbers :
Banking Facilities :
Bank References (b):
Address:
Address:
Account Numbers :
Banking Facilities :
Name of Applicant :
NRIC No :
Designation :
Date :	(mm/dd/yyyy)