ROYAL CANIN MALAYSIA SDN. BHD.

(981744-W) ACCOUNT OPENING

FOR INTERNAL USE ONLY
NEW ACCOUNT SOLE PROPRIETOR POS BDM _____________________ SIGNBOARD

ACCOUNT AMEND SDN BHD / BHD VET ACC NO _____________________

CLASS CODE:
PARTNERSHIP CSO _____________________

CUSTOMER SEGMENT ________________________________________ INDEPENDENT / CHAINS OFFLINE / ONLINE / MIXED CAT / DOG / BOTH

CUSTOMER BUSINESS INFORMATION

COMPANY STAMP
COMPANY REGISTERED NAME
(ACCORDING TO REGISTRATION)

SHOP / CLINIC NAME

(IF DIFFER FROM ABOVE)

ADDRESS GPS CODE

N E
BILLING ADDRESS
(LEGAL ADDRESS)
POSTCODE CITY STATE & COUNTRY SHOP / CLINIC STAMP

ADDRESS

DELIVERY ADDRESS
(IF DIFFER FROM BILLING ADDRESS)
POSTCODE CITY STATE & COUNTRY GPS CODE

N E

OWNER
TEL NO. EMAIL
(ACCORDING TO REGISTRATION)

MOBILE NO. EMAIL

PERSON-IN-CHARGE
(IF DIFFER FROM OWNER, LETTER OF
APPOINTMENT IS REQUIRED)
MOBILE NO. EMAIL

OPERATION ARRANGEMENT

BUSINESS HOUR

OFF DAY MON TUES WED THURS FRI SAT SUN

REMARKS

BRANCH INFORMATION
ATTACHED ADDITIONAL
NO. OF BRANCH NO. OF SHEETS
SHEETS (YES/NO)

SUPPORTING DOCUMENTS REQUIRED (ATTACH)

REGISTRATION DOCUMENTS IC OF OWNER NAME CARD

THE INFORMATION PROVIDED IN THIS FORM WILL BE COLLECTED AND PROCESSED IN ACCORDANCE WITH THE PRIVACY POLICY OF
ROYAL CANIN MALAYSIA SDN BHD, WHICH CAN BE READ HERE: http://www.royalcanin.my/node_824809/privacy-statement

NAME:
DATE: