Account Setup

Electronic debit order agreement
For more information contact 021 201 0500

Get Started

External Sales Source:
Depot:
New/Existing Customer:	New or returning customer?
Application Type:
Billing Method:
Customer ID:	This can be found on your Lanline Invoices.
Agent Code:
Sales Rep.:

Customer Info.

Company Name:
Firstname:
Lastname:
Reg number:	Only valid registration numbers should be entered. If no registration number, then please select "SA ID number" or "Other" for an alternative form of identification.
Vat number:
Contact Person Firstname:
Contact Person Lastname:
Contact Person Cell:	eg: +27781234567
Contact Person Landline:	eg: 0211234567
Contact Person Email:
Street Address:
Street Address (Opt.):
Suburb:
City:
Province:
Postal Code:
Country:

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Verifying info, please be patient.