NOVOBIS MANGGA DUA SQUARE COMPANY PROFILE
VENDOR / SUPPLIER DATA
COMPANY NAME :
ADDRESS :
PHONE NO. :
FAX NO. :
E-MAIL ADDRESS :
CONTACT PERSON ( SALES ) :
MOBILE PHONE :
CONTACT PERSON ( AFTER SALES SERVICE ) :
MOBILE PHONE :
BANK ACCOUNT DETAILS
1. ACCOUNT NAME :
BANK NAME & BRANCH :
ACCOUNT NO. :
2. ACCOUNT NAME :
BANK NAME & BRANCAH :
ACCOUNT NO. :
OTHERS INFORMATION
AGREED TERM OF PAYMENT :
CONTACT PERSON FOR INVOICING :
PAYMENT SYSTEM : PAYMENT BY BANK TRANSFER ( ANY BANK CHARGES
WILL BE APPLIED TO THE SUPPLIER)
SUPPLIER CODE (for internal use only ) VERIFIED BY (for internal use only
)
JAKARTA,……………..……………
(…………………………..………..)
Authorized person + Company stamp
Note: - please complete this form & send back to Account Payable (Fax# 021 - 6231 3687).
- if there any changes for the above information, please inform us immediately so we can update our database.
- if no information to us about the changes, it means our current database is still valid.