Vendor Registration

REGISTRATION OF VENDORS

APPLICATION/UPDATE FORM

PARTICULARS OF COMPANY

Registered Name of Company



Registered Address



State     Postcode

Correspondence Address



State     Postcode

Ownership Status Company Registration




Date of Incorporation Nature of Business

    / / (dd/mm/yyyy)

Core Business

1)      2)      3)
4)      5)

Telephone Numbers

1) -      2) -

Facsimile Number

     -

Treasury Registration Certificate number (If Any)



Type of Permit Permit Expiry Date

          / / (dd/mm/yyyy)

Please fill up all the nine forms before you submit.

Vendors Application/Update Form - Page 2

MANAGEMENT STRUCTURE

Shareholders and percentage holding (from Form 24)

Name

Bumiputra/Non-Bumiputra

Percentage (%)

(1)

(without %)

(2)

(without %)

(3)

(without %)

(4)

(without %)

(5)

(without %)

(6)

(without %)

Board of Directors (from Form 49)

Designation

Race

(1)

(2)

(3)

(4)

(5)

(6)

Vendors Application/Update Form - Page 3

COMPANY PERSONNEL

Company Management and Professional Personnel

Name

Position

Years of Experience

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

Other Staff

Total

Semi-Professional

Supervisory

Skilled Labour

Administration

Others

Vendors Application/Update Form - Page 4

FINANCIAL STRUCTURE

Authorized Capital (RM)

Paid-up Capital (RM)

Working Capital (RM)

Banker(s)

Name of Bank Address Credit Facility (RM)

(1)
Credit      :
Overdraft :

(2)
Credit      :
Overdraft :

(3)
Credit      :
Overdraft :

(4)
Credit      :
Overdraft :

Vendors Application/Update Form - Page 5

CURRENT PROJECT

List the projects that your company is currently engaged in:

Description of Project Customer's Name & Address Contact Person Project Value(RM) Year Of Project

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

Vendors Application/Update Form - Page 6

PLANT AND EQUIPMENT

Details of plant and equipment owned/lease by your company

(from Borang A - Lesen Mesin Cetak)

Equipment/Plant No of Units Equipment Speed Equipment Size Manufacturer Year of Purchase Equipment Function Other Remarks

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

(13)

(14)

(15)

Note : This part is optional. Please proceed to the next form if it is not relevant to you.

Vendors Application/Update Form - Page 7

TRANSPORTATION

Type of Vehicle

Tonnage

Permit No.

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

Vendors Application/Update Form - Page 8

WAREHOUSE

Warehouse Location

Size of Warehouse (sq. m.)

Value of Stock (RM)

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

Vendors Application/Update Form - Page 9

STATEMENT OF UNDERTAKING

We hereby certify that all the information here is correct at the time of application. PNMB has the right
to reject this application due to incorrect information provided in this form.

Filled-up by     :
E-mail             :

Approved by    :
E-mail Address :

PARTICULARS OF COMPANY
Registered Name of Company

Registered Address
State Postcode
Correspondence Address
State Postcode
Ownership Status		Company Registration

Date of Incorporation		Nature of Business
/ / (dd/mm/yyyy)
Core Business
1) 2) 3) 4) 5)
Telephone Numbers
1) - 2) -
Facsimile Number
-
Treasury Registration Certificate number (If Any)

Type of Permit		Permit Expiry Date
		/ / (dd/mm/yyyy)

	MANAGEMENT STRUCTURE
	Shareholders and percentage holding (from Form 24)
	Name	Bumiputra/Non-Bumiputra	Percentage (%)
(1)			(without %)
(2)			(without %)
(3)			(without %)
(4)			(without %)
(5)			(without %)
(6)			(without %)
	Board of Directors (from Form 49)	Designation	Race
(1)
(2)
(3)
(4)
(5)
(6)

	COMPANY PERSONNEL
	Company Management and Professional Personnel
	Name	Position	Years of Experience
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
	Other Staff		Total
	Semi-Professional
	Supervisory
	Skilled Labour
	Administration
	Others

	FINANCIAL STRUCTURE
	Authorized Capital (RM)
	Paid-up Capital (RM)
	Working Capital (RM)

	Banker(s)
	Name of Bank	Address	Credit Facility (RM)
(1)			Credit : Overdraft :
(2)			Credit : Overdraft :
(3)			Credit : Overdraft :
(4)			Credit : Overdraft :

	CURRENT PROJECT

	List the projects that your company is currently engaged in:
	Description of Project	Customer's Name & Address	Contact Person	Project Value(RM)	Year Of Project
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)

	PLANT AND EQUIPMENT

	Details of plant and equipment owned/lease by your company
	(from Borang A - Lesen Mesin Cetak)

	Equipment/Plant	No of Units	Equipment Speed	Equipment Size	Manufacturer	Year of Purchase	Equipment Function	Other Remarks
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
Note : This part is optional. Please proceed to the next form if it is not relevant to you.

	TRANSPORTATION

	Type of Vehicle	Tonnage	Permit No.
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)

	WAREHOUSE

	Warehouse Location	Size of Warehouse (sq. m.)	Value of Stock (RM)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)

	STATEMENT OF UNDERTAKING
We hereby certify that all the information here is correct at the time of application. PNMB has the right to reject this application due to incorrect information provided in this form.
Filled-up by : E-mail :
Approved by : E-mail Address :