Distributorship Application Form
Orion Gas Limited
Distributorship Application Form
Name Of the Business Organization ..............................................................................................................
Name Of Busiess Owner ................................................................................................................................
Applicants Photograph
(2 Copies Attested)
Applicant’s Address
Present ..............................................................................................................................................
..............................................................................................................................................
Permanent ........................................................................................................................................
..............................................................................................................................................
Contact Details
Cell ..................................................... Mobile ...................................................
Fax ..................................................... E-Mail ....................................................
National ID no of Applicant .............................................................................................................
Emergrncy Contact
Name ................................................................................................................................
Address .............................................................................................................................
Contact No .......................................................................................................................
Business Information
Current Business (Types) 1. ...............................................................................
2. ...............................................................................
3. ................................................................................
4. Others ....................................................................
Address of Current Business
Present ..............................................................................................................................................
..............................................................................................................................................
Permanent ........................................................................................................................................
..............................................................................................................................................
TIN no .............................................................................................................................................................
Trade License no ............................................................................................................................................
Do you have experience as Distributor in LPG sector Yes/No
Propose Area/Territory
District Name .........................................................................................................................
Thana Name ..........................................................................................................................
If you are currently in LPG Distributionship Business, Describe your Portfolio below
Company Name
|
Investment
|
Source of Investment (Own/Loan/Others)
|
Monthly Turnover
|
Duration of Business
|
Remarks
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Can you Currently Facilitate a warehouse? Yes/No
If yes, please provide details
Warehouse Address .......................................................................................................................................
Ownership Details Owned/Rented/Lease
Area in sqft .....................................................................................................................................................
Cylinder Storage Capacity in pcs ....................................................................................................................
Do you have own transportation facilities? Yes/No
If yes, please provide details
Vehicle Type
|
No of Vehicle
|
Cylinder Capacity
|
Truck
|
|
|
Pick-Up
|
|
|
Open Van
|
|
|
Others
|
|
|
Personnel Details of your Organization
Description
|
No of People
|
Monthly Salary
|
Remarks
|
Manager
|
|
|
|
Sales Man
|
|
|
|
Delivery Man
|
|
|
|
Others
|
|
|
|
Financial Aspects
Funding status in order to receiving the ‘Orion LPG’ Distributionship
Own Fund (BDT) ................................................................................................................................
From Bank .........................................................................................................................................
Details of Bank(s) you maintain your regular transaction with
Name of Bank
|
Branch
|
Monthly Transaction (BDT)
|
|
|
|
|
|
|
|
|
|
Current Credit Arrangement with any Bank?? Yes/No
If yes, please give details
Name of Bank
|
Branch
|
Arrangement
|
Credit Limit
|
|
|
|
|
|
|
|
|
|
|
|
|
Mode of Payment you wish to Maintain DD/TT/Pay Order/On-Line
The following papers/documents are required to be enclosed herewith the application form
-
An application on company letter head
-
Two copies of passport sized photographs
-
Trade license (Attested Photocopy)
-
TIN certificate (Attested Photocopy)
-
VAT ragistration (Attested Photocopy)
-
NID Photocopy
-
Explosive license (Attested Photocopy)
-
Bank Statement of last 6 months
“I hereby certify that the above statements are correct in all respect. Any false statement if arises will cause cancellation of my distributionship.”
Applicant’s Signature
Applicant’s Name
Date & Seal
Please send the completed application to:
Orion LPG Limited
Enter Address Here
Orion House, 153-154 Tejgaon Industrial Area, Dhaka- 1208, Bangladesh. Tel : +88-02-8870133, +88-02-8870108. E-mail : orion@orion-group.net, Web : www.orion-gruop.net Orion Gas ltd, Plot no : 1-2(A), Mongla Port Industrial Area, Mongla bagerhat, E-mail : info@oriongas.com.bd, Web www.oriongas.cpm.bd Page
Dostları ilə paylaş: |