Bejaan Distributor Data Collection Form 1 2 3 4 Last Page Section 1: Distributor Type Distributor Type * Select the type of distributorshipSuper Sole DistributorSole DistributorSub Distributor (SD) Select the type of distributorship Next Section 2: Location Details Country: * Select CountryPAKISTAN Province/State of Operation Enter your provincePunjabSindhBalochistanKPKAJKGB Division: Enter your divisionMirpurMuzaffarabadPoonch Division: Enter your divisionBaltistanDiamerGilgit Division: Enter your divisionSibiZhobKalatNasirabadQuettaMakranLoralaiKachi Division: Enter your divisionBannuDera Ismail KhanHazaraKohatMalakandMardanPeshawar Division: Enter your divisionBanbhoreHyderabadKarachiLarkanaMirpur KhasShaheed Benazir AbadSukkur Division: Enter your divisionBahawalpurDera Ghazi KhanFaisalabadGujranwalaLahoreMultanRawalpindiSahiwalSargodha District: Describe any vehiclesMirpurBhimberKotli District: Describe any vehiclesMuzaffarabadHattian BalaNeelum District: Describe any vehiclesPoonchBaghHaveliSudhnati District: Enter your districtBaltistanSkarduKharmangShigar District: Enter your districtDiamerAstore District: Enter your districtGilgitNagarGhizerHunza District: Enter your districtKachi District: Enter your districtAwaranKalatKharanKhuzdarLasbelaMastungWashuk District: Enter your districtLoralaiBarkhanMusakhel District: Enter your districtGwadarKechPanjgur District: Enter your districtNasirabadJafarabadJhal MagsiLehriSohbatpur District: Enter your districtChagaiKilla AbdullahNushkiPishinQuetta District: Enter your districtSibiHarnaiDera BugtiKohluZiarat District: Enter your districtZhobKilla SaifullahSherani District: Enter your districtBannuLakki MarwatNorth Waziristan District: Enter your districtDera Ismail KhanSouth WaziristanTank District: Enter your districtAbbottabadBattagramHaripurLower KohistanMansehraTorgharUpper Kohistan District: Enter your districtKohatHanguKarakKurramOrakzai District: Enter your districtMalakandBajaurBunerChitralLower DirUpper DirShanglaSwat District: Enter your districtMardanSwabi District: Enter your districtPeshawarCharsaddaKhyberMohmandNowshera District: Enter your districtBadinSujawalThatta District: Enter your districtHyderabadDaduJamshoroMatiariTando AllahyarTando Muhammad Khan District: Enter your districtKarachi CentralKarachi EastKarachi SouthKarachi WestKorangiMalir District: Enter your districtLarkanaJacobabadKashmoreQambar ShahdadkotShikarpur District: Enter your districtMirpur KhasTharparkarUmerkot District: Enter your districtShaheed Benazir AbadSangharNaushahro Feroze District: Enter your districtSukkurGhotkiKhairpur District: Enter your districtBahawalpurBahawalnagarRahim Yar Khan District: Enter your districtDera Ghazi KhanMuzaffargarhRajanpur District: Enter your districtFaisalabadChiniotJhangToba Tek Singh District: Enter your districtGujranwalaGujratHafizabadMandi BahauddinSialkot District: Enter your districtLahoreKasurLayyahNarowalNankana SahibSheikhupura District: Enter your districtMultanKhanewalLodhranVehari District: Enter your districtRawalpindiChakwalAttockJhelum District: Enter your districtSahiwalPakpattanOkaraJhelum District: Enter your districtSargodhaBhakkarKhushabMianwali City: Office/Warehouse Address: Office/Warehouse Picture Maximum file size: 10 MB Upload or take a picture of the distributor's office/warehouse for verification. Back Next Section 3: Business Details Company/Business Name: * National Tax Number (NTN) : * Years in Business * Select Years in BusinessLess than 1 year1-3 years4-7 years8+ years Owner Full Name * Primary Contact Number: * Format +92 123 4567890 Alternate/Emergency Contact Number: Format +92 123 4567890 Email Address: * Provide the distributor's CNIC * Format: 3730112345678 Location of Distributor: Name of Sales Team Member * Back Next Consent and Declaration SectionSubmission Instructions for Sales Team: Ensure all mandatory fields marked with an asterisk (*) are completed. Verify the accuracy of the distributor’s CNIC and contact details. Capture or upload all required images (office, warehouse, and applicant). Discuss and confirm the product interest categories with the distributor. Submit the form immediately after completion. Ensure the form is filled on Distributor’s location I agree to our Term of Use and Privacy PolicyTo continue, please agree to our GDPR terms by checking this box Submit
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