Request For Registration As An Approved Supplier On The Supplier Database Of The Department Trade And Industry (Page 8 of 11) in pdf

Request For Registration As An Approved Supplier On The Supplier Database Of The Department Trade And Industry Page 8

Head Office Only

Captured By:

Date Captured:

Authorised By:

Date Authorised:

SUPPLIER MAINTENANCE:

Supplier code:

Enquiries. :

BAS

PMIS

LOGIS

WCS

CONTRACTOR

Tel. No.:

CONSULTANT

OFFICE: ……………………………

The Director General :

DEPT TRADE AND INDUSTRY

I/We hereby request and authorise you to pay any amounts, which may accrue to me/us to the credit

of my/our account with the mentioned bank.

I/we understand that the credit transfers hereby authorised will be processed by computer through a system

known as "ACB - Electronic Fund Transfer Service", and I/we understand that not additional advice of payment

will be provided by my/our bank, but that the details of each payment will be printed on my/our bank statement

or any accompanying voucher. (This does not apply where it is not customary for banks to furnish bank

statements).

I/we understand that the Department will supply a payment advice in the normal way, and that it will indicate

the date on which the funds will be made available on my/our account.

Please ensure

This authority may be cancelled by me/us by giving thirty days notice by prepaid registered post.

information is validate as per required bank screens .

I/We understand that bank details provided should be exactly as per the records held by the bank.

I/We understand that the Department will not assume responsibiliy for any delayed payments, as a result of

incorrect information supplied.

Company / Personal Details

Registered Name

Trading Name

Tax Number

VAT Number

Title:

Initials:

First Name:

Surname:

Address Detail

Payment Address

( Compulsory if Supplier )

Postal Code

New Detail

New Supplier information

Update Supplier information

Supplier Type:

Individual

Department

Partnership

Company

Trust

Other ( Specify )

Department Number

Request For Registration As An Approved Supplier On The Supplier Database Of The Department Trade And Industry Page 8

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