General Information

Business Name *

Business Hotline *

Email *

Business Reg. No. *

Business Registration Date *

Address

Business Address *

District

Province

Country

Primary Director / Partner

01) Full Name

01) Permanent Address

01) NIC Number

01) Mobile Number

2nd Director / Partner

Click NEXT if not applicable

02) Full Name

02) Permanent Address

02) NIC Number

02) Mobile Number

Other Directors / Partners

Submit the details of other directors / partners (Full Name, Permanent Address, NIC Number & Mobile Number)

Click NEXT if not applicable

Other Directors / Partners

Vehicle Category

Workshop Record Maintenance *

Name of System (If Computerized

Other Details

Other Service Dealership Brands

Remarks