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					                                      DEALERSHIP APPLICATION FORM

                                                       General Information
Business Name:                                                         Year 1st Registered:
Business Address:
Delivery Address: (if different)
Nature of Business:                                                    Total No. of Employees:          No. of years in Operation:

Dealer Classification:             []   Corporate      []   Retail   []      Distributor   [ ] Others
Office Phone No.:                                                      Office Fax No.:
Web / Email Address:
Name of Owner / Director:
Name of contact person for payment:
Estimated amount of monthly purchases:

                                                   For Provincial Clients Only
Preferred Forwarder / Cargo:
Forwarder / Cargo Contact Person:                                      Forwarder / Cargo Contact Number:
Forwarder / Cargo Address:

                                                        Type of Company

                        []   Sole Proprietorship               []    Partnership              []   Corporation

Sec No. / DTI Reg. No.:
Date Issued:
Amount Capital: (Sole Proprietorship)
Authorization Capital: (Partnership or Corporation)
Subscribed Capital: (Partnership or Corporation)
Paid Up Capital:
Tax Account. No.:
Documents Required
      -   Copy of SEC / DTI Registration Certificate
      -   Company Profile
      -   TIN / VAT Registration

             Related / Affiliated companies currently trading with Lenotech Corporation
1.)                                                                    2.)
3.)                                                                    4.)

                                                       Contact Information
                                      Name                  Direct Line / Cell phone No.                Email              Birth Date

President:

General Manager:

Sales Manager:

Purchasing Manager:

Other Purchaser:

                       1.)

                       2.)
                                                       Bank References
  Name of Bank/Branch Address             Tel. No.:      Savings Acct. No.      Current Acct. No.      Remarks ( For Lenotech use only)

1.)
2.)

             Primary Suppliers (IT-related industry, purchased during the last 12 months)
Name of Company/ Contact Person           Tel. No.:      Length of     Credit Terms   Credit Limit     Remarks ( For Lenotech use only)
                                                         Business
1.)
2.)
3.)
4.)
5.)
*IT-Related industry, purchased during the last 12 months

                                                       Products Carried



                                                       Delivery Schedule
                                Day                                                                  Time




                                                      Products of Interest

               []    A4tech Accessories    [ ] Lenovo Desktops and Notebooks          []   Mars Casing      []   Apollo UPS
                                            [ ] Dynamo Power Supply      []       Seagate




Terms and Conditions:

      1.       The dealer agrees to pay cash on the first transaction.
      2.       Terms will only be given after submitting the proper documents and after the credit investigation has taken place
               and upon approval.
      3.       Only checks with the accredited accounts specified in the Bank Reference will be accepted.
      4.       Delivery lead time shall depend on the availability of stock.
      5.       All sales are final

               I certify that all information provided above are true and correct. I hereby authorize Lenotech Corporation to
           perform the necessary investigation of the above information.

           Name: __________________________

           Signature: _______________________

           Position: ________________________


For use by Lenotech Corporation

Date: _______________________                                            Referred by: _______________________
Terms of Payment: _______________________                                Credit Limit: _______________________
Account Location:     _______________________                            Account for: _______________________
Recommended By: _______________________                                  Approved By: ______________________
Remarks:
______________________________________________________________________________________________________


Recorded By: _______________________
                Credit and Collection

				
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posted:2/2/2011
language:English
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