New Customer Questionnaire

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Company Form

The purpose of this questionnaire is to provide all necessary information that will enable Jelvix to check and prepare all legal, financial, and project documents.

The questionnaire has to be filled in and submitted in English ONLY

1

CUSTOMER’S GENERAL INFORMATION

Please enter your Company Name
(as it appears on the Certificate of Incorporation or equivalent documents)

REGISTRATION DETAILS

Please enter your Number
Please enter your VAT Number

REGISTERED ADDRESS

Please enter your Number and street
Please enter your City
Please enter your State
Please enter your Postal Code
Please enter your Country

PHYSICAL ADDRESS

CONTACT DETAILS

Please enter your Phone
Please enter valid email address
2

REPRESENTATIVE’S (SIGNATORIES) INFORMATION

#1

Please enter valid Name
Please enter valid Position
Please enter your Date of Birth
Please enter valid Contact information
3

FINANCIAL INFORMATION

4

REQUESTED SERVICES

Please choose any services
5

DOCUMENTS

Please choose any Documents
6

OTHER INFORMATION

Please enter from 25 to 500 characters

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Thank you for your application!

We will contact you within one business day.