CNIC No.	--
NTN No.
STR No.
Company's (Registered) Name:
Company's Altername Name (If Applicable):
Company's Permanent (Registered) Business Address
ZIP/Postal Code:
Company's Alternate Address and Postal Code:
Permanent Active E-mail Address:
Country:
Business Phone Number (1):
Business Phone Number (2):
Fax Number:
CONTACT PERSON   First Name:     Middle Name:     Last Name:     Designation:
SUPPLIER'S BANK DETAILS
Bank Name:
Branch Code:
Branch Address:
BANK ACCOUNT DETAILS   Account Title:     Account Type:     Account Number:
SUPPLIER'S LOCAL AGENT DETAILS (IF APPLICABLE)
Company's Name of Local Agent (1):
Supplier Code of Local Agent:
Permanent Business Address:
Zip Code:
SUPPLIER'S LOCAL AGENT DETAILS (IF APPLICABLE)
Company's Name of Local Agent (2):
Supplier Code of Local Agent:
Permanent Business Address:
Zip Code:
Verification Code: