BTH

New Customer Application Form

AR-004 REV 9 · Ban Teck Han Enterprise

Important: Credit application form and ACRA business profile may be required for credit terms above 21 days.

Customer General Information

Company / Outlet Name *

Company Reg. No.

GST Reg. No.

Billing Address

Street Name *

Building / Food Court Name *

Unit No. *

Postal Code *

Delivery Address

Street Name *

Building / Food Court Name *

Unit No. *

Postal Code *

Finance

Contact Name *

Contact No. *

Email *

Sales

Contact Name *

Contact No. *

Email

Declaration

I/We declare that the information furnished on this form is true and complete.

I agree to the declaration above *

Authorised Signatory Name

Title

Date