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Online Dealer Application Form
Company Name* :
Address* :
Contact Name
Contact Number
Business Type* :
Proprietor
Partners
Sdn Bhd
Bhd
Listed*
Year Established* :
No. of Employees* :
Authorised Capital :
Paid Up Capital :
Business Registration / Incorporation No.* :
Date :
Email* :
Website :
Existing Major Creditors :
Banker (s) Name/Branch :
A/C No :
Registration Form :
*Supported Format: jpg, jpeg.
Max Size: 5MB
Workshop Photo :
*Supported Format: jpg, jpeg.
Max Size: 5MB
Workshop Photo :
*Supported Format: jpg, jpeg.
Max Size: 5MB
Others Photo :
*Supported Format: jpg, jpeg.
Max Size: 5MB