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Select User Role* ---Select--- Customer Wholesaler - Wholesaler Role

Company Registration Form or Partnership Certificate or Sole Proprietorship Certificate

NIC / Driving License of the Dealer

If VAT, VAT Registration Certificate issued by IRD

If SVAT, SVAT Registration certificate issued by IRD

Dealer off set letters

First Name

Last Name

Company

Country

Street Address

Address 2

State / County

Town / City

Postcode / Zip

Phone

Custom Code