CREDIT APPLICATION FORM

Issue No: HOT-ACC-REV003-FRM-001

Issue Date:2017 11 01
Page 1 of 1

Company Information

Company Name :

Company Registration GST Registration

Number : Number :

Address :

Contact person : Position :

Tel No : Handphone : Fax No. : Email :

Invoice Address :
(If different)

Company Type :

Sole Proprietor Partnership Private Limited Company Public Listed Company

Banker Name
And Address :

Bank Account Number : Bank Swift Code :

Credit Amount Terms : Application Date :

Required : (No. of Days Required)

Trade Reference - Please list two (2) trade references

Name & address : Name & address :

Contact Person : Contact Person :

Tel. Number : Tel. Number :
Email : Email :

Submitted By :

Name : Signature :
Position : Date :

FOR OFFICE USE ONLY

Checked by : Date :
Approved by : Date :

Credit Limit :

Notes : Kindly attach Form 9, Form 24 and Form 49 with your application. Our company may conduct our due diligence which may
include RAMCI check.