National Client-Supplier Registration Form
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ScribdTranslationsNational Client-Supplier Registration Form
Translated by
ScribdTranslationsNATIONAL CLIENT-SUPPLIER FORM
New Client Date of Fabrication The Comprehensive Solution
Update Day Me Year
Organism Code (1) No. Tax Identification (NIT) (3)
National Client or Supplier Code (2) Commercial Registration Number (4)
Subordination (5) Nac. Prov. Mpal.
Name of National Client or Supplier (6)
Organism Type (7) External Interior
Address Number
Between Cast
Municipality Province
Fax Official email(8)
Phones
BANKING DATA
Title (9) Bank Account Number Bank Currency
AUTHORIZED PERSONS TO SIGN CHECKS OF THE ENTITY (10)
Name and Surname Cargo Company
Name and Surname Cargo Company
First and Last Name Cargo Company
First and Last Name Cargo Company
First and Last Name Cargo Company
I HEREBY CERTIFY
a) That the Entity I represent, whose data is specified in this National Client-Supplier Form,
is interested in becoming a client of Copextel S.A.
b) That the Entity I represent will keep Copextel S.A. informed about the
changes that take place in the future, in the data and in the documents provided when requesting
the inclusion in the Client Registry.
c) That the products marketed by Corporación Copextel S.A. that are acquired by the Entity that
will be used exclusively for internal use and/or consumption of the same, or for the
performance of the activities that have been legally approved.
FROM THE PRESIDENT, MANAGER, GENERAL DIRECTOR
SEAL OF THE ENTITY Name and Surname
Identity Card
Company
AUTHORIZED PERSONS TO SIGN CONTRACT
Name and Surname Cargo Company
Name and Surname Cargo Company
Nombre y Apellidos Cargo Company
AUTHORIZED PERSONS TO MAKE PURCHASES OR RECEIVE SERVICES
Name and Surname Identity Card Number Company Products Services
Contact Email
Guidelines for filling out the Customer Sheet
Write the number of the organization to which it belongs according to the classification of the National Statistics Office (ONE)
Write the specific code.
(3) Enter the tax registration number.
Enter the Commercial Registry number, if applicable.
(5) Mark if the organization's subordination is National, Provincial, or Municipal.
Full name of the company or entity.
Mark 'external' when the Client does not belong to the COPEXTEL corporation.
Official e-mail address of the company or entity.
Name of the account holder of the bank account that finances the purchase.
All persons authorized by the company or entity to sign checks.
Authorized persons to make purchases and receive services at COPEXTEL.
(12) Mark with a cross if you want your entity to be a supplier for COPEXTEL.
Do you wish to certify your entity as a supplier of products and/or services for COPEXTEL?
SI_____ NO______
Any modification of this data must be reported immediately to COPEXTEL. The compliance with this requirement is the responsibility of the client.
If the client does not update the data on this form, once the validity period has expired, COPEXTEL will not be able to provide its services.
This certificate is valid for 2 years from its date of issue.
FOR COPEXTEL USE
Code Limitations
Observations
CLIENT FILE VALIDATED BY
Validada por: Approval Date Validator's Signature
Day My Year
Approved by: Fecha de Aprobación Signature of the Responsible Party