E-Invoicing

* 1. Customer Number: (refer to KPM's Statement of Account)

* 2. Company Name: (as per SSM Registration)

* 3. Old Business Registration Number (For business)

* 4. Business Registration Number (Please provide New Number) - (for business)

* 5. Identification Number (for individual)

* 6. Tax Identification Number (TIN)

* 7. SST Registrant

Yes No

* SST Registration Number (Format - xxx-xxxx-xxxxxxxx)

* 8. Company Address

* City

* Post Code

* Country

* State

Different Address

Yes No

* 9. Email Address (use for e-invoice)

* 10. Contact Number (Office)

* 11. Contact Number (Mobile)

12. Shipping address same with above.

Yes No

* 13. Shipping Recipient’s Name

* 14. Old Business Registration Number (For business)

* 15. Business Registration Number (Please provide New Number) - (for business)

* 16. Identification Number (for individual)

* 17. Tax Identification Number (TIN)

* 18. Company Address

* City

* Post Code

* Country

* State

* 19. Contact Number (Office)

* 19. Contact Number (Mobile)

Recipient’s Name	Business Registration Number	Identification Number	Tax Identification Number	Company Address	Contact Number	Action

* Remark

* 20. I, the Authorised Person hereby certify and confirm that the all information requested and provided in the form is true and accurate.

* Authorised Person’s Full Name

* Authorised Person’s Position

* Company Name