Online Submission

1

Company Name* This field is required.This will be the entity/name reflected in our invoices and other documents

(e.g. ABC Coffee Company Pte Ltd)

2

Entity Type* This field is required.

Private Limited

Partnership

Sole Proprietorship

3

Company Registration Number

4

Estimated Annual Green Coffee Usage* This field is required.Cumulative yearly coffee roasted. Estimated if unknown.

in Kilograms

5

Registered Business Address* This field is required.Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

6

Business Type* This field is required.

Coffee Roaster

Reseller

7

Company Website

e.g. www.berocoffee.com.sg

8

Company SizeTotal employyes

e.g. 10

9

Paid-Up CapitalIn US Dollars

e.g. 10,000

10

Prior Year RevenueIn US Dollars

e.g. 100,000

11

Delivery Address* This field is required.Primary address of destination of coffee beans.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

12

Primary Contact* This field is required.

First Name

Last Name

Job Title

13

Primary Contact Office Phone Number* This field is required.

Country Code (e.g. +65)

Phone Number

14

Primary Contact Mobile Phone Number* This field is required.

Country Code (e.g. +65)

Phone Number

15

Primary Contact Email Address* This field is required.

example@example.com

Secondary Email Address

17

Accounts Department Contact

Prefix

First Name

Last Name

18

Accounts Phone Number

Country Code (e.g. +65)

Phone Number

19

Accounts Mobile Number

Country Code (e.g. +65)

Phone Number

20

Accounts Email

example@example.com

21

Authorized Signatory Name* This field is required.

Prefix

First Name

Last Name

Job Title (e.g. Director)

22

Authorized Signature* This field is required.

Clear

23

Would you like to be included in our Price and Stock List Updates?* This field is required.Market information, latest arrivals, latest spot offers, announcements and others will be included in the blast

YESNO

24

Please Upload Your Business Registration Certificate* This field is required.If you do not have one or unsure, your appointed Trader from Bero Coffee Singapore will contact you.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

(e.g. ACRA, import license etc)

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