Please enable JavaScript in your browser to complete this form.Company Information Company Name: _______________________ Registration Number/Tax ID:________________________ Website: ___________________________ Contact Information IContact Person: ___________________________ Position: ___________________________ Email: ___________________________ Phone: ___________________________ Billing Address: ___________________________ Shipping Address: ___________________________ Contact Information IIContact Person: ___________________________ Position: ___________________________ Email: ___________________________ Phone: ___________________________ Billing Address: ___________________________ Shipping Address: ___________________________ I Buyer Business DetailsEstimated Monthly Purchase Volume: _________________ Products of Interest: ___________________________ How did you hear about us? ___________________________Bank DetailsBank Name: _______________________ IBAN/BIC: ________________________ Bank Address: ____________________ Account Name: ______________________Payment TypePremiumStandardBasicAttachments Company Registration Certificate:_____________________ VAT Registration: ______________________________ Agreement☐ I confirm the information is correct and I accept the Premium Client Terms & Conditions.BuyerSignature: _________________________________________________Date: _________________________________________SupplierSignature: _________________________________________________Date: _________________________________________Submit
