Account number (for office use only) Company name Email address Registered name of dealer Trading name of dealer Previous trading/registered name of dealer Incorporated form of business VAT registration number of entity Are you part of a Yes No holding company? Registered name of holding company Registration number of company Registered names of subsidiary companies SABC realer TV license number (Please provide copy of TV license document in this pack) Physical address “Domicilium” Billing address Postal address Business Business fax telephone number number Main contact First name: Surname: person name
Account number (for office use only) Company name Email address Registered name of dealer Trading name of dealer Previous trading/registered name of dealer Incorporated form of business VAT registration number of entity Are you part of a holding company? Yes No Registered name of holding company Registration number of company Registered names of subsidiary companies SABC realer TV license number (Please provide copy of TV license document in this pack) Physical address “Domicilium” Billing address Postal address Business telephone number Business fax number Main contact person name First name: Surname:
Rectron-dealer-application-1.docx