EXCEL RADIANCE
GOLD AND DIAMOND JEWELRY
Email info@excelradiance.com
Phone +97 145 707416
Address Office Number 438 Building 6EB, Dubai Airport Freezone, Dubai, UAE
NEW ACCOUNT / KYC (KNOW YOUR CUSTOMER) APPLICATION
Please complete this application in full and submit it to our accounts team for review.
Business Details
Legal Business Name *
Business Address *
City *
State & Zip
Tel *
Fax
Email *
D.B.A / Trade Style & Mailing Address
D.B.A / Trade Style
Mailing Address (if different)
City
Cell
Web URL
Business Information
Federal Tax ID
JBT ID
Resale Tax
Type of Business RetailWholesalerManufacturer
Legal Status of Organization Private CorporationPartnershipIndividual
Years in Business
Years at Present Location
State of Registration / Incorporation
Person Responsible for Accounts Payable
Contact Number
Email Address
Owners / Authorized Persons Responsible for Purchasing
Person 1
Full Name
Title
Resident Address
Phone
Social Security
State ID
Email
Person 2
Trade References (3 Required)
Company Name 1 *
Phone *
Company Name 2 *
Company Name 3 *
Supporting Documents (Upload)
Reseller / Tax Exemption Certificate (if applicable)
ID / Company Registration Document (optional)
Authorization & Signature
Applicant Name *
Date *
Applicant Signature *
