Dealership Form

Applying for*
- Silver Dealership
- Gold Dealership
Company Profile
Business Name*
Website
Telephone Number*
Fax Number
Address*
Street Address Address Line 2 City ZIP / Postal Code
Year Established*
Nature of Business*
Products and Services Offered (Please provide attachments if necessary)

*

Products	Brands	Manufactured At

Business Information
Type of Business*
- Corporation
- Partnership
- Sole Proprietorship
Business License No.*
Issued On*

Name of Partners (if Partnership) or Name of Incorporators (if Incorporation)*

Full Name	Position	Address

Affiliated Company / Branches / Other Offices*

Brand / Affiliate	Address	Telephone No.

Present Suppliers*

Company	Address	Telephone No.	Industry	Products Purchased

Bank References*

Bank	Branch	Contact Numbers

President / Owner Details
Name*
First Last
Mobile Number*
Telephone Number*
Fax Number
Email*

AUTHORIZED PERSONNEL
Sales
Primary Sales Person*
First Last
Position*
Email*
Mobile Number*
Telephone Number*
Fax Number
With Alternate Sales Person*
- Yes
- No
Alternate Sales Person*
First Last
Position*
Email*
Mobile Number*
Telephone Number*
Fax Number
Purchasing
Primary Purchasing Person*
First Last
Position*
Email*
Mobile Number*
Telephone Number*
Fax Number
With Alternate Purchasing Person*
- Yes
- No
Alternate Purchasing Person*
First Last
Position*
Email*
Mobile Number*
Telephone Number*
Fax Number*

Accounting
Primary Accounting Person*
First Last
Position*
Email*
Mobile Number*
Telephone Number*
Fax Number
With Alternate Accounting Person*
- Yes
- No
Alternate Accounting Person*
First Last
Position*
Email*
Mobile Number*
Telephone Number*
Fax Number
Technical
Primary Technical Person*
First Last
Position*
Email*
Mobile Number*
Telephone Number*
Fax Number
With Alternate Technical Person*
- Yes
- No
Alternate Technical Person
First Last
Position*
Email*
Mobile Number*
Telephone Number*
Fax Number
Other Requirements*
1. Company Profile 2. SEC /DTI Registration 3. Articles of Incorporation 4. BIR Registration 5. Business Permit 6. Organizational Chart 7. Signature Specimens of all Authorized Personnel

Bank Information Request
Please fill-up so we may submit information from your bank.
Dealer / Company Name*
Contact Person*
First Last
Address*
Street Address Address Line 2 City ZIP / Postal Code
Bank Information
Bank Name*
Address*
Street Address Address Line 2 City ZIP / Postal Code
Contact Person*
First Last
Telephone Number*
Account Name*
Account Number*

Signatories*

No. of years banking there*
Authorized*
- I authorize MySolutions to inquire about my credit standing with the above name bank.
Authorized by*
First Last
Designation / Job Title
Department*
Date*
CAPTCHA
Certify*
- I herby certify that all information given is true and correct, and agree to notify MySolutions, of any changes thereon. I authorized MySolutions Inc. to investigate all information and references contained in this profile sheet.

For dealership inquiries, please contact:

cathy@mysolutions.ph | noel.cabutin@mysolutions.ph | carloliquino@mysolutions.ph

| 09913386465 | 09324779450 | 09176265781
(02) 401-5956 | (02) 8-547-5497

Step 1 of 6

Company Profile

Products and Services Offered (Please provide attachments if necessary)

Business Information

President / Owner Details

AUTHORIZED PERSONNEL

Sales

Purchasing

Accounting

Technical

Bank Information Request

Bank Information

Manila Office

Cebu Office

Products

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Dealership Form

For dealership inquiries, please contact:

cathy@mysolutions.ph | noel.cabutin@mysolutions.ph | carloliquino@mysolutions.ph

| 09913386465 | 09324779450 | 09176265781(02) 401-5956 | (02) 8-547-5497

Step 1 of 6

Company Profile

Products and Services Offered (Please provide attachments if necessary)

Business Information

President / Owner Details

AUTHORIZED PERSONNEL

Sales

Purchasing

Accounting

Technical

Bank Information Request

Bank Information

| 09913386465 | 09324779450 | 09176265781
(02) 401-5956 | (02) 8-547-5497