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Merchant Registration Form

Option 1 (USD 200) Option 2 (USD 250) Date: ________________ Personal Information Name: Lau Cheng Shyang Introducer Username:ahpa3 Username:Lau1 E-mail:raito_lau@hotmail.com I/C No:870428355275 Tel No:0165001388 Fax No: Address:39, Jalan Senangin, Taman Sri Tenggara Post Code:34200 City:Parit Buntar State:Perak Country:Malaysia

Company Information Company Name: Tel No: Address: Post Code: Country:

H/P No: City:

Co. Registration no: Fax No: State: Co. Website:

Bank Details Payment to be made payable to: Cimb bank Account No: 08060081654529 I/C No: 870428355275 * I/C number is required for bank-in arrangement to personal account.

Note:

1. It will take approximately 7 to 10 working days for your products to be listed online. 2. All products purchased will be inclusive of delivery charges ADDED to the selling price by the merchant unless otherwise stated. 3. Boss Venture reserves the rights to accept or reject any product upload request. 4. Kindly read the Terms & Conditions attached and acknowledge by signing it.

** Please look at overleaf on Company's Terms & Conditions **

Product Information *please e-mail all information to bossventure.merchant@ymail.com


Product Name: Coco mocha Categories (eg: Fashion/Health Product) :Health Product Product Dimension: Height (cm) 10 Product Format: Physical Product Width (cm) 5 E-Voucher Lenght (cm) 5 Service Product

Product Description: Health Product Product Feature:Health Product Quantity: 600 set Transaction Option: Retail Price: RM210 Unlimited Consignment Weight: 50 Presold Cost Price to Boss Venture: RM300 (30% discount and above) Warranty (optional):

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