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Distributor Registration

Company Details
Company Name *	:
Company Registration No. *	:
Full Mailing Address *	:
City *	:
State *	:
Postal *	:
Phone No. *	:
Fax No. *	:
Email Address *	:
Nature of Business *	:
Type of Location *	:	Retails Office Warehouse Others Please select your type of location.
Do you have a showroom? *	:	Yes No Please select your option.
If 'No', do you plan to have one? Add your comments *	:
Owners and Managers
Name *	:
Address *	:
Email Address *	:
H/P No. *	:
Position *	:
SSM Registration Type *	:	ROC (Registrar of Companies) ROB (Registrar of Businesses) Please select your SSM registration type.
Upload (Form 9 (Memorandum And Article of Association) / From D (SSM)) *	:

Security Code *	:	Please click here to generate code. Please enter security code.