Create | GA

Step 1

Step 2

Step 3

Personal Details

Select Vendor

Resident Status

Proposer Type

Vendor Type

First Name

Middle Name

Last Name

Company Director Name

Tax PIN

VAT No.

Alternate Email

Date Of Birth

Business Name

ID Type

Certificate of incorporation No./or Business Registration No.

IRA Reference No./Ref Number

IRA Expiry

Contact Details

Mobile No.

Alternate Mobile No.

Telephone No.

Website Url

Building

Street

Postal Address

Physical Address

Postal Code

Town

County

Region

Branches/Outlets

Select Branches/Outlets

Qualified or Not Qualified

VAT

WHT

PI Cover

PI Cover Expiry

Bank Details

Transaction Type

Is Preferred ?

Bank Name

Branch Name

Swift Code

Account Name

Bank Account Number

Currency Type

IBAN

Is Mobile Wallet Transaction ?

Mobile Transaction

Mobile Transaction No.

Mobile Wallet Payment Type

Mobile Wallet

Paybill No

Account Number

Till No

Mobile Number

Auditors

Describe the nature of business the vendor is involved in

Reference Details

COMPANY NAME *	CONTACT PERSON *	DESIGNATION *	CONTACT NO *	EMAIL ADDRESS *	ACTION

Has your company ever been in a dispute with a client over supply of goods or services ?

Have you ever supplied goods or services to GA? If so indicate the type of goods/ services provided ?

Credit Terms

Vendor Form

Personal Details

Contact Details

Branches/Outlets

Bank Details

Reference Details