SME Vendor Detail Form

Section 1: Vendor Information

Business Vendor
Trading No (if
Name Known)
Business Category / Product
Address

Compan Cell
y Number
Registra
tion No
VAT No E-mail
Address

Section 2: Business Information

Firm of Accountants Number of Stores

Bank Name National

/
Regional
Bank Branch Buyer (If Known)
Supplier

Sharehol Type of Enterprise

ding (EME, QSE, Generic)
Ownersh
ip Section 3: Job Information
DetailsNumber
% of Jobs Created Gender & Race Race & Total
Year Direct / Indirect Male Female Youth
2015 BLACK ()
2016 INDIAN ()
2017 COLOURED ()
2018 WHITE ()
2019
2020
Declaration

Name In Print Signature Title Date

Office Use Only

Company Profile or Business Plan
Copy of B-BBEE Certificate / EME / QSE Affidavit
Copy of Recent Annual Financial Statements
Copy of VAT registration or VAT Number
Copy of Company Registration Certificate
Once Completed email smallbusiness@pnp.co.za