KUDRAT GROUP OF COMPANIES

WISMA KUDRAT, NO. 20, LORONG KELULI 1B, KAWASAN PERINDUSTRIAN BUKIT RAJA,
SEKSYEN 7, 40000 SHAH ALAM ,SELANGOR .
TEL : +063 3362 0000 FAX : +603 3362 0013
CREDITOR APPLICATION FORM
Kudrat Entity Name: FLEET CARE MALAYSIA SDN BHD

Document to be submitted together with this application . Tick when document are attached .
a) Business Registration / Company Profile
b) Form 9 and Form 49 / Form 24
c) Memorandum and Articles of Associations
d) Bank Statement First Page (with address / acc number / branches)

(A) Particular of Company / Business

1) Name:

2) Business Address :

3) Business Contact Name :

4) Business Contact Email :

5) Account Dept. Contact Name :

6) Account Dept. Contact Email :

7) Office Phone No : 8) Mobile Phone No :

9) Company / Business Registration Number :

10) Incorporation Date : 11) Date Commencement of Business:

12) Nature of Business :

13) Legal Constitution : Sole Proprietorship Partnership Sdn. Bhd. Bhd

( Tick where appropriate )
14) Paid Up Capital :

15) Banker's information

a) Bank Country :

b) Name of Bank :

c) Branch Address :

d) Account Holder Name :

e) Bank Acc/IBAN Number :

f) Bank Key/Swift Code :

 KUDRAT GROUP OF COMPANIES
WISMA KUDRAT, NO. 20, LORONG KELULI 1B, KAWASAN PERINDUSTRIAN BUKIT RAJA,
SEKSYEN 7, 40000 SHAH ALAM ,SELANGOR .
TEL : +063 3362 0000 FAX : +603 3362 0013
CREDITOR APPLICATION FORM
Kudrat Entity Name:

(B) Particular of Proprietors / Partners / Directors / Senior Management

Name Designation Contact No .

1)

2)

3)

(C) CREDITOR DECLARATION

Name : Designation :

Signature : Company Chop :

Date :

FOR OFFICE USE ONLY

Recommended by:
Name : Designation :

Signature : Date :

Review by:

Name : Designation :

Signature : Date :

Approved by:

Name : Designation :

Signature : Date :

FOR FINANCE DEPARTMENT

Identification Created in Accounting System

Creditor Name : Designation :

Creditor ID : Date :

Created by :