Registration Form

    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

    Email

    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

    2. valid Bank confirmation letter (confirming bank details)

    3. valid Tax Clearance Certificate

    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to be processed by the AMS, consent is effective immediately and will remain effective until such consent is withdrawn.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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