Distributorship Form

DISTRIBUTORSHIP APPLICATION FORM

TRADING HISTORY AND AUTHORIZATION

Are You a distributor to any company? If so, give name and category of distributorship , product and the year of your business with them.

Your Authorized Representative/Manager's particulars.

II)

For Incorporated or Business registration companies, please attach a copy of your CAC Registration Certificate. Please note that all information in this application will be treated as confidential, but we reserve the right to make enquiries regarding the status of any applicant.

This form is not an offer. Further developments shall be communicated to you in due course.

UNDERTAKING

do hereby undertakes that, if appointed as a distributor I/We shall abide by the all rules and regulation laid down by the company.

Sign

Date

FOR OFFICIAL USE ONLY

1. Report of Area Sales Rep.

i) Facilities Available:

a) Warehouse (size)

b) Distribution Vehicle(s)

ii)Location suitability

iii) Survey of current business activity and prospect for our co. products

Sign

Date

2. HMD’S Remark

3. Recommendation by GM-FGS

4. Approval by MD

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