Nagaworld Limited

Supplier Creation Form

Date:
Please √ on below: Documents Submitted:
□ New Supplier Creation □ Patent Tax Identification
□ Change Payment Term [Supplier Code: __________ ] □ Company Registration/ Cert of Incorporation
□ Change Payee Name [Supplier Code: ___________ ] □ Photocopy of ID (Payee)
□ Bank account details (i.e. account no. etc)
□ Original invoice (as sample purpose)
Supplier Particulars
1 Supplier/Company Name
េ ះ កមហ៊ុន/ អកផត់ផង់

2 Company Registration Number

េលខចុះប ីេ ះ កមហ៊ុន
3 Company VAT Registration (VATTIN)
េលខអតប
4 Office Address
ស័យ ន កមហ៊ុន

5 Contact Details (Sales Person) េលខទូរសព័បុគលិកសំ ប់ទំ ក់ទំនង

Name
េ ះ
Mobile Number
េលខទូរសព័ៃដ
Telephone
េលខទូរសព័េលតុ
Fax
េលខទូរ រ
Email Address
ស័យ នអុីែម៉ល
6 Payment Term
រយៈេពលទូរ ត់ ក់
7 Payee Name*
េ ះអក តវបង់ ក់េ យ*

8 Bank Account No.

េលខគណនីធ រ

9 Bank Name & Branch

េ ះធ រ&

10 Description of Goods to be Supplied

េរ ប ប់មុខទំនិញែដល តវផត់ផង់

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 11 Declaration of Any Relatives working in YES / NO (If yes please indicate the name below)
Nagaworld ប ក់េ ះ បសិនេប ន
ប់េ ះអកែដល ល់ ច់ តិេធ
រ រេ ( បសិនេប ន)

i.
ii.
iii.

12 Company Portfolio (Please name a few customer reference in hospitality industry)

សូមប ក់េ ះ កមហ៊ុនេផ ងៗែដល កមហ៊ុនអក នផត់ផង់

i.
ii.
iii.

13 Has any management of your company been employed by Nagaworld within the last three years.
េត នគណះ គប់ គង មួ យកុ ង កមហុ៑នរបស់អក ប់ បុ គលិក កំ លុងេពលបី ំមុន

□ Yes ន □ No អត់

*We request you to make payment to our company in the above payee name. We will be responsible for any liabilities
that may arise at any time as a result of this request.
េយងខុំសូមេធ រេសសុំកុ ង រទូ ត់ ក់សំ ប់ កមហ៊ុនេយងខុំេ កុងេ ះដូ ច ងេ ម។ េយងនឹ ង ទទួ លខុ ស តវ
ចំេ ះប បំណុល មួយែដល ចេក តេឡងេ េពលមួយ ែដល លទផលៃន រេសរសុំេនះ ។*

______________________________
Company Signature and Stamp
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______________________________ ______________________________
Reviewed By Cost Controller Reviewed By Purchasing Manager

______________________________
Approved By Financial Controller

For Office Use:

□ Finance created in Sun system Date:____________ By:_________________

□ Cost Control created in MC system Date:____________ By:_________________

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