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VELX Mart

Customer Creation / Dealership Form

Cattle Feed & Fish Feed — apply for dealership or register as a customer. Fields marked with * are required.

I. Basic information
II. Constitution of distributor
III. Manpower
IV. Sales record
V. Infrastructure
VI. Bank details
VII. Territory & business commitment
VIII. Documents provided

Tick the copies you will submit (in triplicate where required).

IX. Declaration & signature

I/We hereby confirm and certify that the information and attachments given herein are true and accurate. Any subsequent changes will be duly communicated to VELX / IB group by submission of a fresh form along with relevant supporting documents.

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