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Dear Supplier,
Please select a Business Unit and complete the following information to enable Agera to update all your company information on our system.
Choose Division
(Required)
AudioNote
Coresol
Wires & Wireless
Supplier Information
Company Name
(Required)
Reg No
(Required)
Vat No
Phone
(Required)
E-mail Address
(Required)
BEE Compliance Level
Physical Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Postal Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Account Name
(Required)
Bank Institution
(Required)
Account No
(Required)
Branch Code
(Required)
Branch Name
(Required)
Credit Limit
(Required)
Payment Terms
(Required)
Type Of Business
Corporation
General Partnership
Pty Ltd
LLC
Sole Partnership
Other
Please Specify
Director Name
(Required)
Telephone No
(Required)
E-mail Address
(Required)
Financial Manager Name
(Required)
Telephone No
(Required)
E-Mail Address
(Required)
Debtors Contact Person
(Required)
Telephone No
(Required)
E-mail Address
(Required)
In addition to the completion of the Supplier Information document, we require the following information to be attached to the document.
1. Copy of Company Registration Documents
(Required)
Drop files here or
Select files
Max. file size: 64 MB.
2. Copy of Vat Registration Documents
(Required)
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Select files
Max. file size: 64 MB.
3. Valid SARS Tax Clearance certificate
(Required)
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Select files
Max. file size: 64 MB.
4. Copy of BEE certificate
(Required)
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Select files
Max. file size: 64 MB.
Name
This field is for validation purposes and should be left unchanged.
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