1.
REGISTERED BUSINESS NAME:  
     
2.
TRADE NAME OF APPLICANT (e.g. Shop Name, Company Name):  
     
3.
TYPE OF BUSINESS:  
     
4.
YEAR OF ESTABLISHMENT:  
     
5.
No. OF STORES AND LOCATION(S):  
     
6.
CONTACT NAME & POSITION:  
     
7.
PHYSICAL ADDRESS:  
     
8.
POSTAL ADDRESS: