Company Purchase Form

APPLICATION FORM

A. COMPANY DETAILS

Company Name *
Business Type
Address *
Telephone Number *

REPRESENTATIVE DETAILS

Name
Contact Number
Email
Position

ITEM

C. APPLIANCE REQUESTING FOR

Name of Item Requesting For *
Proposed Duration to Pay For Item *
Payment Type *

FINANCING AGREEMENT

Initial Deposit Agreement *

CLIENT'S DECLARATION

CLIENTS INITIALS

SIGN YOUR INITIALS BELOW TO AGREE TO THE ABOVE DECLARATION *I declare that the above information to the best of my knowledge. In support of my application, i understand that if any of the information I have provided proves to be false, it will lead to the automatic decline of my request. If it is found out that any of the information I have provided proves to be false after delivery of item, City Hire Purchase has the right to retrieve the item. I consent to CHP in connection with this application, making such enquiries about my affair as it deems fit I will also be available for further discussions upon request.
Date *
Upload Business Registration *
Upload Commerce of Business Certificate *

TERMS AND CONDITIONS

Verification

Please enter any two digits *Example: 12
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