E-Payment Registration Form

New Registration

Change of Detail

Part (A) Beneficiary Details

Name of Applicant/Vendor
Co./ Business
Registration No.

NRIC No.
(e.g 811212011212)

Bus. Address

Telephone No.

Mobile No.

Person In Charge
PIC Tel No.
Email Address
(For Payment Notification)

Part (B) Beneficiary Bank Details (Please ensure information included herein is exactly as provided to/by the bank.)
Name Of Bank
Bank Address

Bank Account No

Swift Code

Bank Branch
Type of Account

Saving

Current

Others, please specify.

Part (C) Declaration

I, the authorized officer and representative of the above named vendor, agree to TIME paying us via the relevant e-payment
system. We warrant that the information provided herein is true and accurate, and the bank account details is that of
vendor/s. We will hold TIME harmless and free from any liability whatsoever, so long as TIME relies upon the information
provided herein.

Signature of authorised officer/representative

Company Stamp

Name of authorised officer/representative

Date
TIME means any company in the TIME Group that has contracted with the vendor.

Part (D) For Office Use Only

Department

Date

Verified By

Date

Approved By

Date

Updated in SAP By

Date

Notes:
1.This facility allows payment to be credited into the above mentioned account only.
2. Please attach (i) copy of NRIC or Passport or Business Registration Form whichever is applicable and (ii) 1st page of (a) your bank statement or; (b) your saving book showing the
account name and account number; or (c) details of your bank account obtained from your bank's website that has been certified by your bank; or (d) letter from your bank confirming
your bank account details.