Suppliers

Section 1:
COMPANY/ SUPPLIER DETAILS

Legal name of company (required)

Trading name of company (required)

Income Tax Reference number (required)

VAT registration number

Company registration number

Close corporation registration number

Number of full time employees

Section 2.
CONTACT DETAILS

Postal Address of company

Physical address of company

Business telephone *

Mobile phone number

Fax Number

Website

Email Address

Toll free number

SECTION 3
MAIN CONTACT PERSON IN YOUR ORGANISATION

Name

Job Title

Telephone Number

Fax Number

Email Address

SECTION 3
MAIN CONTACT PERSON RESPONSIBLE FOR SALES IN YOUR ORGANISATION

Name

Job Title

Telephone Number

Fax Number

Email Address

Section 4.
COMPANY STOCK CLASSIFICATION

Beauty spot (PEBS)Beverages & Cereals (PEBC)Biscuits/ Chocolate/ Candy/ Gum (PEBIS)Book shop (PEBK)Condiments (PECOS)Drinks (PED)Frozen foods (PEFF)Mother care (PEMC)Household (PEHS)Spirits & Wimes (PESW)Village market products (PEVM)Others...Other:

describe other

Section 5.
ACCOUNT DETAILS

Account Details

Branch

Account Number

Contact Person

Phone Number

Email Address

Section 6.
NAMES OF ALL OWNERS, DIRECTORS AND RESPECTIVE DESIGNATIONS

Section 7:
SUPPLIER GROUPING DETAILS

Type of firm: Please tick the relevant
Public Company (LTD)Private company (PTY)Close Corporation (cc)Joint VentureConsortiumSole ProprietorForeign CompanyPatnershipTrustSection 21 CompanyGovernment/ ParastatalOther:
Specify:

Status of enterprise
MicroSmallMediumLargeOther:
Specify:

Declaration of any other conflict of interest:

Comments/Notes