AMS VENDOR FORM
Section A: VENDOR INFORMATION
Supplier Trading Name
Specify Product or Service Type
Company Registration Number
(if applicable)
Vat Registration Number
(if applicable)
Tax Clearance Number
(if applicable)
Accountable Manager:
Accounts Contact Person:
First Name & Surname
Phone No
Physical Address
Postal Address
Section B: PROVIDE SUPPORTING DOCUMENTS
Please indicate that you have provided the following supported (if applicable)
1. valid B-BBEE Certificate or Sworn Affidavit
—Please choose an option—AttachedNot Attached
2. valid Bank confirmation letter (confirming bank details)
—Please choose an option—AttachedNot Attached
3. valid Tax Clearance Certificate
—Please choose an option—AttachedNot Attached
Section C: VERIFICATION
I hereby verify that the contents of this document are valid at the date of signature, and I have attached all relevant copies of supporting documentation.
By signing this form, I consent to the company information to be processed by the AMS, consent is effective immediately and will remain effective until such consent is withdrawn.
Name:
Signature:
Designation:
Date:
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