Orion Gas Limited



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növüApplication form



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



  1. An application on company letter head

  2. Two copies of passport sized photographs

  3. Trade license (Attested Photocopy)

  4. TIN certificate (Attested Photocopy)

  5. VAT ragistration (Attested Photocopy)

  6. NID Photocopy

  7. Explosive license (Attested Photocopy)

  8. 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



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