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Tank Application Form

This document is an order form for a tank from Tile and Carpet Center Limited, requiring member details such as full names, ID number, and membership number. It includes sections for payment mode, receiver's information, and official authorization from Harambee Sacco. A sketch map for the final destination is also included for delivery purposes.

Uploaded by

Mwangangi Muema
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© © All Rights Reserved
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18 views1 page

Tank Application Form

This document is an order form for a tank from Tile and Carpet Center Limited, requiring member details such as full names, ID number, and membership number. It includes sections for payment mode, receiver's information, and official authorization from Harambee Sacco. A sketch map for the final destination is also included for delivery purposes.

Uploaded by

Mwangangi Muema
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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TOP TANK

ORDER FORM
MEMBER’S DETAILS:
FULL NAMES:…………………………………………………………………………………………………………………………………………….
ID NUMBER:…………………………………………………………………… SERVICE NO/PERSONAL NO:…………………………….
MEMBERSHIP NO:………………………………………………EMPLOYER:……………………………………………………………………
SIGNATURE: ………………………………………………..MOBILE NO:…………………………………………………………………………

DESCRIPTION OF TANK: …………………………………………………………………… QUANTITY ……………………………………………………………………..

MODE PAYMENT: CASH /LOAN /CHEQUE

NAME OF RECEIVER: …………………………………………………………………………LOCATION……………………………………………………………………..

MOBILE NO: ………………………………………………….., MOBILE NO:………………………………………………. MOBILE NO: …………………………….

FOR OFFICIAL USE ONLY: HARAMBEE SACCO AUTHORIZATION

I ………………………………………………………………………………………………………………….. BRANCH ................................................. Harambee


Sacco , authorize Tile and Carpet Center Limited to execute collection by the customer as per above details subject to T & C confir-
mation .

Sacco Branch Official SIGNATURE ………………………………………. ID NO ……...………………………. Stamp ……………………………..

Sketch Map to final destination:

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