Dealer Application Form

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Dealer Application Form

The following information is intended to provide a guideline for new dealership inquiries. If you have any questions regarding these provisions please feel free to contact us for clarification. Our intentions are to provide a fair and beneficial policy to maintain the highest degree of service and security for all of our partners and to best serve the Technological markets as a whole. The primary requirement is that you must have a Computer products related business.

Company Details:

Company Name
Registered Address

Tick the relevant Category

Dealer
Limited Company
Sole Trader
Partnership

Permanent Address

General Information (Business):

Limited Company/ Public Limited Company Registration No.

Partnership Firm Registration No

Delivery Address

Invoice Address

Purchasing Department Details
Name
Tel No.
Fax No.
E-mail

Account Department Details
Name
Tel No.
Fax No.
E-mail

Owner (s) Details:

Directors’/ Proprietor/ Partners’ Full Names and Job Details

Name		Psition
Name		Position
Name		Position

Names of Authorised Signatories

Name		Psition
Name		Position
Name		Position

Commercial Information:

No. of Employees

VAT No.

Associated/ Parent Companies

Name
Name

Date Commenced Trade		Date Financial Year End
Turnover Last Year (Tk.)		Expected Turnover This Year (Tk)
Net Worth (Tk.)		Profit/ Loss Last Year (Tk.)

Business Type

Traditional Dealer
Value Added Reseller
System integrator

Corporate Account Reseller
Retailer
Other

Wholesaler
Mail Order

Bank Name and Address

No. of years account held

Please list all ccj’s against you on a separate sheet

Trade References :

Name

Address

Tel No.

Contact

Length of time with this supplier

Credit Limit (Tk.)

Name

Address

Tel No.

Contact

Length of time with this supplier

Credit Limit (Tk.)

Smart Technologies (BD) Ltd. will deliver to the delivery address above, using its preferred carrier. The cost of this service will be added to the invoice.

Should you wish to collect by hand or authorise your own carrier to collect form our premises, please tick this box. Yes

Market Information:

Which is your primary market?

Main Product lines required?

How did you hear about us?

Which other distributors do you use?

How many PCs/ servers do you build per year?

Turnover Information:

Estimated monthly turnover with Smart Technologies (BD) Ltd. (Tk.)

Declaration :

I declare that I have read and accepted the Trade Agreement Terms, Conditions and Service Policy of Smart Technologies (BD) Ltd. The information I have given above is true and correct. I authorize Smart Technologies (BD) Ltd. to carry out credit checking procedures. I have authority to act as an agent for the company/ partnership/proprietor herein described.

Signature		Date
Name		Position

Attach Reference paper :

Please attach your latest sets of bank account information and a utility bill showing your office address.