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Application - Form - Template Azizi

This document is an application form for a new agency agreement with Azizi Developments. It collects information such as the applicant's company name, trade license number, tax registration number, address, contact details, authorized signatory name and designation, nationality, mode of payment, and bank account details. The applicant also declares that they do not have any relatives employed by Azizi Developments.

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benzpropertiesdxb
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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507 views2 pages

Application - Form - Template Azizi

This document is an application form for a new agency agreement with Azizi Developments. It collects information such as the applicant's company name, trade license number, tax registration number, address, contact details, authorized signatory name and designation, nationality, mode of payment, and bank account details. The applicant also declares that they do not have any relatives employed by Azizi Developments.

Uploaded by

benzpropertiesdxb
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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NEW AGENCY AGREEMENT APPLICATION FORM

Date: _ _ /_ _ /_ _ _ _ SALES EXECUTIVE NAME (AZIZI):

Name of Company/Individual:Benz Properties LLC

Trade License/Passport No.:1233378 TAX REGISTRATION NO (TRN):

RERA Reg.No: 37633

COMPLETE ADDRESS (for communication by courier (MUST BE COMPLETE; OFFICE NUMBER, BLDG NAME / NO,
STREET NAME/NO. CITY, COUNTRY, PO BOX/ZIP CODE ) Office F-031, Sabha Building, Jebel Ali, Dubai

Post Box No.:181231 City:Dubai Zip/Postal Code: Country: _

Phone: Mobile: Fax: _

Official Company Email:

Name of Authorized Signatory (with Power of Attorney Certificate):


Mr. /Mrs. M i s s I f r a h S i d d i q u i e
(As per passport) First Name Middle Name
Last Name

Designation: C o m p a n y O w n e r Nationality: P a k i s t a n i

Mode of Payment: Bank Transfer

Bank Account Details of Agent/COMPANY BANK DETAILS FOR AGENCY: (if its bank transfer)

Account Number: Name of Bank:

Swift/Sort Code:

Beneficiary Name:

IBAN:

I do hereby declare that I do not have any relatives or members of my family within the third
degree either of consanguinity or of affinity who is/are connected/employed with Azizi
Developments as either employee/job order contractor.
Ifrah Siddiquie

Signatory & Company Stamp


*For Individual, please ignore not applicable information

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