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PERSONAL DETAILS Country of Citizenship: _____________________________ Passport number: _________________________ Full name as in NRIC or PAN: __________________________________________ NRIC or PAN No: __________________ Registration User Name (ID): ___________________________________________ Date of Birth: ______________________ Mailing Address: ____________________________________________________ ____________________________________________________ Postcode: _____________________ HP No: _____________________ Email : _____________________________________ BANKING DETAILS Bank name: ______________________________ Branch details: ____________________________________________________ Bank Account No: ______________________________ Account Type: ______________________________
PHYTO SCIENCE SDN BHD Block B, 5-1-4, Megan Salak Park Jalan 1/125E, Desa Petaling 57100 Kuala Lumpur
(1013730P)
Tel: 603-90545250 Fax: 603-90546250
www.iphytoscience.com Email: [email protected] [email protected]
Networker Registration Form Singapore
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Introducer ’s Name: ____________________________________________ Registered User Name: _____________________________________________ Placement User Name: (L/R)_________________________________________ I hereby agree and comply with all the terms and conditions of Phyto Science Sdn Bhd, signed this ___________ day of __________ month, year 20___ (Signature) Desired Package Plan (please check box below) .
USD are exchanged at Ringgit Malaysian rate of 3.40/- per Dollar Singapore Dollars are exchanged at regular bank-rate per USD
Package payments can be made to: Gandiraja A/L Gopalaraj
RHB Bank account 11234900157972 Damansara Utama Branch
47400 Petaling Jaya Selangor, Malaysia
For inquiry please call +60 16341 0136 +60 19276 1610
SGD 137/- (USD98) SGD 823/- (USD 588) SGD2,744/- (USD1,960)
SILVER PACK GOLD PACK MOBILE PACK
USD 3 0 SG D 4 0
USD 8 8 SG D 1 15
USD 1 76 SG D 2 35
USD 3 0 SG D 4 0
USD 1 76 SG D 2 35
USD 2 94 SG D 3 95
USD 3 0 SG D 4 0
USD17 6 SG D 2 35
USD 5 88 SG D 7 94
![· Company Registration Certificate (for example, Form 24 and Form 49 for Malaysia Company; ACRA Business Profile for Singapore Company) C] Company profile, product's catalogue,](https://img.dokumen.tips/doc/110x75/5f75fffeafcdec6c4604bfdf/company-registration-certificate-for-example-form-24-and-form-49-for-malaysia.jpg)
