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Supplier Information Form

This document is a supplier information form that collects key details about a supplier such as business registration numbers, tax registration numbers, address, contact information, payment details, and a declaration. The form collects the supplier name, addresses, phone numbers, email addresses, and two primary contacts. It also requests bank account details and payment currency to set up the supplier for payments. The supplier must declare that the information provided is true and correct by signing the form.

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gros_fi
Copyright
© Attribution Non-Commercial (BY-NC)
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418 views2 pages

Supplier Information Form

This document is a supplier information form that collects key details about a supplier such as business registration numbers, tax registration numbers, address, contact information, payment details, and a declaration. The form collects the supplier name, addresses, phone numbers, email addresses, and two primary contacts. It also requests bank account details and payment currency to set up the supplier for payments. The supplier must declare that the information provided is true and correct by signing the form.

Uploaded by

gros_fi
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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F 1581

Supplier Information Form

Name: ____________________________________

Business Registration No.

Country: _______________________
Address: __________________________________

Tax Registration No. VAT

TAN

* Tick as appropriate

__________________________________
__________________________________

NIC

__________________________________
City: ______________________

State: ______________________

Phone Number: ____________________________

Postal Code: ________________

Fax Number: _____________________________

Email: ___________________________________
Contacts

Contact 1
Last Name

: __________________________

First Name

:_____________________________

Position

:__________________________

Phone No

:_____________________________

Alt. Phone No.

:___________________________ Email

:_____________________________

Last Name

: __________________________

First Name

:_____________________________

Position

:__________________________

Phone No

:_____________________________

Alt Phone No.

:___________________________ Email

Contact 2

:_____________________________

Payment Currency

Payment Currency
Account Number MCB Ltd

Account Number

Currency

Account Number

Currency

Account Number - Overseas Bank

IBAN

MUR

Overseas Bank Details

Bank Name: ________________________________________


Bank Address: ______________________________________
______________________________________
______________________________________
Country: __________________ ___

City: _______________________

Postal Code: _____________

State: _____________________

Swift Code / BIC: _______________________________

Applicable to local suppliers only


Allow Withholding Tax*: Y

MRA Expense Category*

Payments subject to TDS*


TDS Category
Royalties
Rent
Contractors/sub Contractors
Architects
Engineers
Land Surveyors
Project Managers
Property Valuers
Quantity Surveyors

Tax Rate
10%
5%
0.75%

Goods & Services


Professional Fees
Rent
Others

3%
* Tick as appropriate

Declaration of Supplier
I/we .
(Full Name of Signatory/ies in block letters)
declare that the above information is true and correct.
Signature: ______________________________

Signature: ______________________________

Date: ____/___/______

(Affix Company Seal, if applicable)

For Procurement BU Only


Received on: ____/___/______

Checked By: ____________________________

Processed By: ______________________________

Signature: ______________________________

Verified By: ______________________________

Signature: ______________________________

Date: _____/_____/________

For Accountancy BU Only**


Received on: ____/___/______

Checked By: ______________________________

Processed By: ______________________________

Signature: ________________________________

Verified By: ______________________________

Signature: ________________________________

Date: _____/_____/________
**Bank Account set-up

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