FULL REGISTERED NAME OF COMPANY:

BUSINESS REGISTRATION NUMBER:

VAT REGISTRATION NUMBER:

TRADE NAME/S OF BUSINESS:

NATURE OF BUSINESS:

DATE BUSINESS ESTABLISHED:

EMAIL ADDRESS:

TYPE OF BUSINESS: SOLE PROPRIETORPARTNERSHIPCC(PTY) LTDLTD.

REGISTERED ADDRESS OF BUSINESS:

CODE:

CODE:

POSTAL ADDRESS OF BUSINESS:



CODE:

TELEPHONE NO:
FAX NO:
TELEX:

NAMES & ADDRESSES OF DIRECTORS/MEMBERS/PARTNERS/PROPRIETORS:

FULL NAMES

1.

RESIDENTIAL ADDRESS

ID NO./DATE OF BIRT

2.

3.

4.

PREVIOUS NAME OF BUSINESS:

NAME OF HOLDING COMPANY:

NAME OF SUBSIDIARY AND ASSOCIATE COMPANIES:

1.

2.

PREMISES: OWNEDRENTED

NAME OF LANDLORD IF RENTED:

ESTIMATED CREDIT REQUIRED:

BANKERS:

ACCOUNT NO:

DATE OPENED:

TRADE REFERENCES (PLEASE SUPPLY):

NAME

1.

ADDRESS

TELEPHONE NO.

2.

3.

I/We certify that the information given is true and correct. We agree to the terms and conditions set out

Duly authorised signatory:

Designation:

Email:

Date:

"SURETYSHIP:
I, THE ABOVE SIGNATORY, DO HEREBY BIND MYSELF AS SURETY AND CO-PRINCIPAL DEBTOR WITH THE CUSTOMER FOR THE DEBTS AND OBLIGATIONS OF THE CUSTOMER TO FORMS-ELITE & LABELS C.C.. I RENOUNCE THE BENEFITS OF DIVISION AND EXCLUSION.

SIGN: