PMA TOOLS - Account application

Account Opening Form

*Company name:

Additional Company name:

*Commercial Register/ Place of registration:


*Owner Name:
*Owner Name:

*First name:

Date of birth:




Address

*Street:


	*No.:

*ZIP Code:

*City:

*Country:

Delivery address - if different from above

Street:


	No.:

ZIP Code:

City:

Country:

Invoice address - if different from above

Street:


	No.:

ZIP Code:

City:

Country:

*Phone:

Fax:

Email:

Website:




Further references, e.g. persons authorized to make purchases





*Buying group





Contact person

Title:

*Name:

First name:

Phone:

Fax:

Email:

Function:




Contact person 2

Title:

Name:

First name:

Phone:

Fax:

Email:

Function:




Contact person 3

Title:

Name:

First name:

Phone:

Fax:

Email:

Function:




* Mandatory fields

Place, date

Signature of applicant:


- Application form

- Business registration

- Company letterhead