Distribution Application Form

Distributor
Town Zone Sole Distributor
Territory Region Power Distributor
Assigned Geography (Areas/Towns etc):
DISTRIBUTOR BIODATA
Distribution/Firm Name: Owner/Proprietor:

Mailing Address:
Mobile Phone 1: Office PTCL with Area Code:
Mobile Phone 2: Email:

Please tick: Sole Proprietary Firm Partnership Firm Other:____________________

Names of Partners/Directors Role in

Cell Phone Number/s CNIC Number Specimen Signature
(For Partnership firms) Business

Partnership deed required wherever applicable along with partners copies of CNIC.

Sales Tax Registration Number: (Attach copy of registration)

National Tax Number (NTN): (Attach copy of NTN)

Other Businesses:
(From Same Premises)

DISTRIBUTOR INFRASTRUCTURE & INVESTMENT DETAILS

Required Availability/Confirmed Remarks/Timeline
Initial Investment
Sales Reps (Bookers)
Supply Men
Warehouse & Office Space
Computer/KPO etc

OTHER INFORMATION
How did you come to know about this opportunity with the Company? Do you have any relatives/friends working with the Company? If yes
provide names, designation, relation and details?

DECLARATION
I/we hereby confirm that all the above details/information is true to the best of my/our knowledge.
I/we take full responsibility for any misleading and false information provided herein.

Owner and Distribution Authorized Person/s Name & Signature:

Name/s:
Distributor Stamp
Signature:
Date:

OFFICE USE
TSO ZSM Checked (HO) & Code Assigned NSM (Approval)
Name
Date

Signature

House No. 134, Block No 3, Bahadurabad, Karachi