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Niger
Nigeria
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Palestinian Territory, Occupied
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Romania
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Samoa
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Saudi Arabia
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Slovenia
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Somalia
South Africa
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Sudan
Suriname
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Nature of Business
No. of Years in the Business
Name of Principal Stockholders / Officers
1
2
3
4
5
Estimated Monthly Consumption (Diesel)
Estimated Monthly Consumption (Gasoline)
Estimated Monthly Consumption (Bunker Fuel)
Estimated Monthly Consumption (Lubricant)
1.
2.
3.
4.
5.
Banking References
1
2
3
4
5
Supplier Reference
1
2
3
4
5
Stated below are names of persons we hereby certify/authorize to transact on our behalf.
1
2
3
4
Business Docs needed to submit at
omnihck@gmail.com
Department of Trade Registration (DTI)
Securities and Exchange Registration (SEC)
General Information Sheet (GIS)
Financial Statement (FIS)
We hereby certify that all inforamation stated in this Customer Information Sheet and Credit Application are true and correct.
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