Dealer Fill-in Section | |||||||||
Merchant Registration Name | Chinese: | English: | Organization Code* | ||||||
Business License Number | Nature of Business | □ Limited Liability System □ Joint Stock System □ Private Non-Enterprise □ Individual Business □ Other (please specify) | |||||||
Dealer Responsible Person | Document Type | □ ID Card □ Passport □ Other | Document Number | ||||||
Store Information | Registered Name | Same Merchant: □ Yes □ No (Please specify separately) | Yes | ||||||
Business License Number | No | ||||||||
Business Name | Same Store Registered Name: □ Yes □ No (please specify) No | ||||||||
Business Scope | |||||||||
Business Address | Province City (District) Street (Town) Neighborhood Committee (Village) Number | Postal Code | |||||||
Opening Date | Year Month Day | Business Hours | : (a.m.)— : (p.m.) | Business Area | M2 | ||||
Number of Employees | About People | Number of Business Floors | Floors | Average Monthly Revenue Ten Thousand | About Ten Thousand Yuan | ||||
Store Responsible Person | Position | Boss | Contact Number (Landline: Mobile: ) | ||||||
Daily Contact Person | Same Store Responsible Person □ Yes □ No (please specify) Same Store | Name | Position | Contact Number | |||||
Fax | |||||||||
Settlement Information | Account Name | Clearing Account Number | |||||||
Bank Name | Bank City | Bank Contact Number | |||||||
Send Withdrawal Details | Financial Contact Person | Contact Number | |||||||
Merchant Signature | Date | Seal |
Our company's dedicated column | ||||||||||
Name of investment specialist | Salesperson code | Tel | Mobile | |||||||
Promotion method | □ Merchant actively applies □ Actively contact merchants | On-site visit | □ Yes □ No | Verify original documents | □ Business license □ Organizational Chart code certificate Tax proof documents | |||||
Promotion notes | Registered capital | Ten thousand yuan | Merchant establishment date | Year Month Day | Merchant registered address | |||||
Business environment | □ Central business district □ Suburban business district □ Residential small business circle □ Residential area □ Office area □ Industrial area □ Other (please specify) | |||||||||
Store nature | □ Street independent store □ Large shopping mall sales area □ Professional square shop space □ Office building □ Sales counter □ Other (please specify) | |||||||||
Sales method | □ Wholesale □ Retail □ Both wholesale and retail □ Other | Operating channels | □ Store □ Internet □ Phone/Fax □ Other | |||||||
Return policy | □ Non-returnable □ Returnable (specific policy: ) | |||||||||
Assessor's name | Assessor's code | Assessment method | □ Phone □ Internet □ On-site □ Other | |||||||
Assessment notes | Signature: Date: | |||||||||
Person in charge | Signature: Date: | |||||||||
Special application | Applicant: Date: Year Month Day Authorized signatory: Date: |