የንግድ ድርጅት መመዝገቢያ ቅፅ (በኢትዮ ቴሌኮም ሾፕ) MMBD – F01

Organization/ Merchant Registration Form – (through Own Shops) V2

የንግድ ድርጅቱ ዝርዝር መረጃ/MERCHANT/ORGANIZATION BUSINESS DETAIL

ድርጅቱ የተመዘገበበት የንግድ ስም/Registered Business Name _________________________________________

የግብር ከፋይ መለያ ቁጥር/TIN Number _________________________________

የንግድ ሥራ ዘርፍ/Business Sector ____________________________________

ክልል/ከተማ አስተዳደር/Region/Administration City______________ ዞን /ክፍለ ከተማ/Zone /Sub-city ____________

ወረዳ/Woreda _____________ ቀበሌ/Kebele ______________የቤት ቁጥር/House Number _________________

ኢሜይል/Email _______________________________ ስልክ ቁጥር/Contact Number _______________________

አማራጭ ስልክ ቁጥር/Alternative Contact Number _____________________

የንግድ ድርጅቱ አይነት / MERCHANT/ORGANIZATION BUSINESS TYPE

የንግድ ሥራ አይነት /Business type በአካል /Proximity በበይነ መረብ/ Online/Remote

በአካል ከሆነ ቅርንጫፍ አለው? /If proximity, is there branches? አዎ / Yes የለውም/No
ቅርንጫፍ ካለው በዛታቸው/ If Yes, how many branches? _________________
የባንክ መረጃ /Bank details
የባንኩ ሥም/ Bank Name _________________________________
የባንክ ቅርንጫፍ ስም/Bank Branch name _________________________________________
የባንክ አካውንት ቁጥር/Bank account number __________________________________________________
የባንክ አካውንት ባለቤት ስም/Bank account holder name _________________________________________

የንግዱ ባለቤት/ሥራ አስኪያጅ ዝርዝር መረጃ / Business Owner/ Manager Detail

የንግዱ ባለቤት/ሥራ አስኪጅ ሥም/Business owner/Manager Name________________________________

ጾታ/Gender __________ክልል/ከተማ አስተዳደር/Region/Administration City______________ ዞን /ክፍለ

ከተማ/Zone /Sub-city ____________ ወረዳ/Woreda _____________ ቀበሌ/Kebele ______________
የቤት ቁጥር/House Number ____________ ዜግነት/Nationality__________________
ኢሜይል/Email_______________________ ስልክ ቁጥር/Contact Number _______________________
ከላይ የሰጠሁት መረጃ ትክክል መሆኑን በፊርማዬ አረጋግጣለሁ/I certify with my signature that the above
information is correct. ስም/Name________________________ፊርማ/Signature______________
ቀን/Date____________ማህተም (ካለው)/Stamp if applicable_____________
ለውስጥ አገልግሎት/For Office Use Only
አገልግሎት አቅራቢ/ Merchant ድርጅት Organization
የአገልግሎት አቅራቢ/ድርጅት ቁጥር/ Merchant/ Organization Number _______________________________
የኢትዮ ቴሌኮም ዞን/ሪጅን/Ethiotelecom Zone/Region__________የአካባቢ ስም/Specific location _______________________
የጂ ፒ ኤስ አድራሻ/GPS Location _____________________________________
ቅፁን የተቀበለው እና ያረጋገጠው/Received & Verified By ወደ ሲስተም ያስገባው/Captured by

ስም እና ፊርማ__________________________________ __________________________

ቀን/Date____________ ቀን/Date____________

የኢትዮ ቴሌኮም ሽያጭ ማዕከል ማህተም/Shop Stamp _____________________________