Customer Onboarding Form

Sales Executive Information

Sales Executive:

Date:

Signature:

Section 1: Customer Information

Company/Individual Name *

Postal Address

Key Contact Person (if company)

Title

National ID/Passport No. (if individual)

Business Incorporation or Registration No.

KRA PIN

Tax Compliance Certificate No.

Withholding Tax Agent No. (if applicable)

Office Physical Address

City/Town

County of Operation

Country

Company Phone No. *

Company Email Address *

Website (if applicable)

Section 2: Business Details

Nature of Business *

Years in Operation

Primary Business Activity

Estimated Annual Turnover

Company Directors (attach CR12 & ID copies)

Section 3: Product/Service Interest

LPG (Liquified Petroleum Gas)

AutoGas

Diesel

Petrol

Lubricants

Other (specify)

Section 4: Payment Terms and Banking Details

Preferred Payment Method:

Mobile Transfer

Bank Transfer

Credit

Credit Limit Requested (if any)

Secured

Unsecured

Bank Account Details:

Bank Account No.

Bank Name

Branch

Swift Code

Currency

Section 5: Trade References (Company, Contact details)

Section 6: Authorized Signatories

Upload Signature

Section 7: Declaration and Consent

Declaration: I/We hereby declare that the information provided is true and accurate. I/We authorize Trinity Energy (Kenya) Limited to verify the information and documentation submitted for account opening and continued business engagement.

Customer Name / Authorized Signatory *

Designation

Date *

Signature *

Attachments Checklist

Certificate of Incorporation/Registration

CR12 (valid)

KRA PIN

Tax Compliance Certificate

Director IDs

Business Permit

Withholding tax agent (if applicable)

Bank account details