DEALERSHIP ACCREDITATION FORM
COMPANY PROFILE
BUSINESS NAME :
MAIN OFFICE ADDRESS :
CONTACT # :
FAX # :
YEAR ESTABLISHED :
NATURE OF BUSINESS :
:
BUSINESS INFORMATION
TYPE OF BUSINESS : CORPORATION SOLE PROPRIETORSHIP PARTNERSHIP
BUSINESS LICENSE # : ISSUED ON :
NAME OF PARTNERS (IF PARTNERSHIP) OR NAME OF INCORPORATORS (IF CORPORATION)
NAME POSITION ADDRESS
OTHER OFFICES/ AFFILIATED COMPANY / BRANCHES
BRANCH /AFFILIATE ADDRESS CONTACT #
BANK REFERENCES
BANK BRANCH CONTACT #
PRESENT SUPPLIERS
COMPANY PRODUCTS PURCHASED CONTACT #
OWNER/ DIRECTOR/PRESIDENT
COMPLETE NAME :
LANDLINE # :
MOBILE # :
EMAIL ADDRESS :
If you have any questions , Please contact Mary May on Tel no. (032) 324 8917
THANK YOU FOR YOUR BUSINESS!
AUTHORIZED PERSONNEL
SALES
NAME :
POSITION :
TEL # :
MOBILE # :
SIGNATURE (SPECIMEN) :
DELIVERY ACCEPTANCE
NAME :
POSITION :
TEL # :
MOBILE # :
SIGNATURE (SPECIMEN) :
ACCOUNTING
NAME :
POSITION :
TEL # :
MOBILE # :
SIGNATURE (SPECIMEN) :
PURCHASING
NAME :
POSITION :
TEL # :
MOBILE # :
SIGNATURE (SPECIMEN) :
REQUIREMENTS
COMPANY PROFILE ORGANIZATIONAL CHART
BUSINESS PERMIT BIR REGISTRATION
DTI/SEC REGISTRATION
IF SEC, ARTICLES OF INCOPORATION
If you have any questions , Please contact Mary May on Tel no. (032) 324 8917
THANK YOU FOR YOUR BUSINESS!
BANK INFORMATION REQUEST FORM
Please fill out this form so we may submit for information from your bank. Thank you.
Dealer/Company Name
Address
Contact Person
Bank Information
Bank Name/Branch
Address
Telephone No./Fax No.
Contact Person
Account Name
Signatories
Account No.
No. of years banking there
I authorize SYSTEMHUB DISTRIBUTION INC to inquire about my credit standing with the above
named bank. Please accept my signature as permission to furnish SYSTEMHUB with this information.
Signature over printed name _________________________________
Title ________________________________
Date __________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
For Bank Use Only
Dear Bank Officer:
The above company has given your name as the Bank holding their accounts. Any information you may give will be
helpful in our decision to open an account for them. The information provided to our company will be held strictly confidential.
Please complete this form and send through email: sales@systemhub.ph at your earliest convenience. Above is their
written authorization for access.
Checking Account Information
Date Opened _________________________________________________________________________________
Average Daily Balance _________________________________________________________________________
Properly handled?
OverDraft(OD)? Yes ______ No ________ How often?______________
Drawn Against Uncollected Deposits (DAUD)? Yes ______ No ________ How often?______________
Drawn Against Insufficient Fund (DAIF)/ Returned Checks? Yes ______ No ________ How often?____________
Any additional comments _______________________________________________________________________
Savings Account Information
Date Opened ______________________________________
Average Daily Balance ______________________________________
Any additional comments ______________________________________
Prepared by: __________________________________ Date: _______________
Designation : __________________________________
