ONLINE ENTERPRISE Sole Proprietor Trading Partnership REGISTRATION FORM - Daftar Niaga

1. CHOOSE YOUR ENTERPRISE Sole Proprietor / Partnership Company NAME

FIRST NAME :	(Compulsory)
SECOND NAME :	(If Any)
THIRD NAME :	(If Any)
FOURTH NAME :	(If Any)
FIFTH NAME :	(If Any)

2. PARTICULARS OF COMPANY OWNER

2.1 FIRST OWNER - COMPULSORY

FULL NAME :
NRIC NO :	- - xxxxxx - xx - xxxx
DATE OF BIRTH :
SEX :
HOME ADDRESS :

CITY :
POSTCODE :
STATE :
COUNTRY :
MOBILE PHONE :
OFFICE TELEPHONE :
HOME TELEPHONE :
FAX NO. ( If Any ) :
E-MAIL ( Required ) :


2.2 SECOND OWNER - IF ANY

FULL NAME :
NRIC NO :	- - xxxxxx - xx - xxxx
DATE OF BIRTH :
SEX :
HOME ADDRESS :

CITY :
POSTCODE :
STATE :
COUNTRY :
MOBILE PHONE :
OFFICE TELEPHONE :
HOME TELEPHONE :
FAX NO. ( If Any ) :
E-MAIL ( If Any ) :


3. COMPANY PRINCIPAL ACTIVITIES

TYPE OF BUSINESS :
BUSINESS ADDRESS :

BUSINESS PHONE :
FAX NO. ( If Any ) :


4. PAYMENT INFORMATION
COST - RM 400 - All Inclusive

PAYMENT DETAILS - Please Make Payment - RM 400.00
PAYMENT BY :
METHOD :


5. QUESTIONS & COMMENTS - IF ANY

QUESTIONS / COMMENTS:





NOTE* Cost Per Enterprise / Sole Proprietor/ Partnership Registration - RM 400.00 (All Inclusive) Please fax us a copy of all the owners Identity Card ( Enlarge Double Size ) To Fax Number 03 - 4042 0723 OR DIRECT BANK-IN AT PUBLIC BANK Hero Ventures Sdn Bhd - Account No. 31059 23209 DIRECT BANK-IN AT MALAYAN BANKING Hero Ventures Sdn Bhd - Account No. 514477-103050 DIRECT BANK-IN AT BUMIPUTRA-COMMERCE BANK Hero Ventures Sdn Bhd - Account No. 1420-0004977-059 Please scan a copy of all the owners Identity Card and send by email to Hero@DaftarNiaga.com Any Questions Please Contact Us Now Office Tel No : Cik Ira 4041 0000, 4041 4000, 4043 4000 4044 3000, 4044 4000, 4044 6000 4044 7000, 4044 8000, 4044 9000 Fax No : 03 - 4042 0723 Mobile : 019-394 0000 / 016-286 0000 / 012-3900 700 / 019 - 384 0000 - Mr RUSTUM