NORTHPORT (MALAYSIA) BHD
APPLICATION FOR CREDIT FACILITIES
1. Name of Company : ………………………………………………………………..
2. Business Address : …………………………………………………………………
………………………………………………………………………………………
3. Registered Address : ……………………………………………………………….
………………………………………………………………………………………
4. Telephone Nos :……………………………… Fax No :……………………….…
5. Business Regn. / Inc No. ……………………………….. Date : …………………
6. Type of Company : Public Listed / Private Limited / Partnership / Sole Proprietor
/ Others. (Delete as applicable)
7. Principal Activities : Shipping / Container Operator / Forwarding / Total Logistics
/ Transportation / Importer & Exporter / Manufacturer / Trader/ Haulier/Others
(Delete as applicable)
8. Estimated monthly value of business with Northport: RM………………………
(The amount of BG will be based on 2months volume)
9. Estimated monthly number of TEUs to be handled ( If applicable) : ………………...
10. Person to contact regarding payments: …………………………………………….
Telephone No. ………………………..
Facsimile No: …………………………
Email address : ……………………………………………………………………..
11. Person authorized to download e-bills :………………..…..…………….…………
Email address :……………………………………………………………………...
12. Name and address of principal Banker : …………………………………………...
…………………………………………. A/C No. …………………………….….
We confirm that all the information given above is true and complete.
………………………………
Company stamp & signature
….…………………………………
Name of signatory & designation
Date : ……………….
NOTES: Please attach copies of the following certified true documents when
submitting this form.
a)
b)
c)
d)
e)
Memorandum and Articles of Association;
Form 13, if any;
Forms 24
Form 49;
Last 2 years’ Audited Accounts or the latest Bank Statement
For Northport’s use
Company Status
………………………………………………………………………
Director Status
………………………………………………………………………
………………………………………………………………………
Recommendation
………………………………………………………………………
Approved / Not Approved
Bank guarantee quantum or deposit required: RM ______________________
……………………………
Head, AR Finance
……………………...
Date