NEW SUPPLIER FORM

For official use only

Vendor Number: Local/Global Supplier:
Legal screening done: Entity(s) to be invoiced:
Vendor validation done: Once off / ongoing purchases:

Submitted by:
Submitted to:
Date:

COMPANY PROFILE

COMPANY NAME: REGISTRATION NR:

TRADING AS (If applicable): VAT REGISTRATION NR:
TYPE OF COMPANY: (PTY / CC) CONTACT PERSON:
PHYSICAL ADDRESS: TELEPHONE:
MOBILE:
FAX:
COUNTRY: E-MAIL:
POSTAL CODE: WEBSITE:
POSTAL ADDRESS:
(if not same as above) PLANT:
PAYMENT TERMS:
COUNTRY:
POSTAL CODE:
B-BBEE LEVEL (South Africa Only):
NATURE OF BUSINESS: 1
2
3

BANKING DETAILS

ACCOUNT NAME:
ACCOUNT TYPE:
BANK NAME:
BRANCH CODE:
ACCOUNT NUMBER:
SWIFT/IBAN

DOCUMENTS ATTACHED

COMPANY REGISTRATION CERTIFICATE: B-BBEE CERTIFICATE:

TAX CLEARANCE CERTIFICATE: COMPANY PROFILE:
BANK DETAILS CONFIRMATION: DUE DILIGENCE QUESTIONNAIRE:
LETTER OF GOOD STANDING: SIGNED MUTUAL NON DISCLOSURE

ADDITIONAL COMMENTS

COMPLETED BY: SIGNATURE:

DATE:

NSF.SA.01 535926751.xls