ADDENDUM A : CUSTOMER REGISTRATION FORM

Request Date: Request Type:

New Customer Add
Change Terminate : Reason

Effective Date: 1. CUSTOMER INFORMATION

UPS Account Number : Account Type: Company Name: Address: Address: Pincode: Website: Attention : Address Type: (If differs from the above address) Company Name : Address: Address: Pincode: Attention: City: Title : State
Pick Up Pick Up Parent Account Number Billing

Expiry Date:
Child Account Number Import

Special Shipping Code:

Export
Delivery Address

City:

State: Emaid ID : Title :

Billing Import

Country:

Telephone:

Department:
Export Delivery Address

Fax:

Country: Department:

India

Telephone: Fax:

2. CONTACT INFORMATION
Contact Type: Contact Name: Telephone: Contact Type: Contact Name: Telephone: Extension:
Pick Up Export

Pick Up

Export

Billing

COD

Accts Payable

Decision Maker

Claims

Third Party

Import

Title: Extension:
Billing

Department: Email Address:

Accts Payable Decision Maker

Fax:
COD

Email Opt-In * Claims Third Party

Import

Title: Fax:

Department: Email Address:

Email Opt-In *

3. FINANCE INFORMATION
Billing Term:
Prepaid Freight Collect 3rd Party

Outbound Credit Limit: Inbound Credit Limit:

Outbound Credit Term: Inbound Credit Term:

Business Registration Number:

Billing Cycle :

Daily

Weekly

Fortnightly

Monthly

4. LIST OF ACCOUNT NUMBERS - Only the accounts number(s) listed here are eligible for Discount/Rates UPS Parent Account Name: Child Acct: Company Name & Address Child Acct : Company Name & Address

Type of Company :

MNC

Subsidairy of MNC

Proprietorship

Public

Private

Government

5.SERVICE INFORMATION
Center # : Pick Up Time : Shipping Tool: 0:00
World Ship

Route: to
Campusship

0:00
Worldease

Closing Time
UIS Airwaybill

0:00

Pick Up Point :
E Billing QVM

Pieces per Month :

Import Control Other

Paperless Invoice

Customer Classification (Potential Gross Rev $) : Top Reasons to shift to UPS: Commodity Shipped : Requirement for Supply Chain Solutions:
Air Freight
Ocean Freight
SLIC Code (4 Digits-Code) :

Warehousing & Distribution

Supplier Management

Other

No Requirement

6.PRICING REQUIREMENT
Bid type: Competitors: SIC Code:
Regular Adhoc

Bid Reason:
Others (Pls specify):

Conversion

Penetration

Retention

Template Code:

Committed Gross Revenue:

SIC Description
AE Name: Approved by:

7. ACCOUNT EXECUTIVE INFORMATION

AE Code:

Processed by:

Date:
Addendum B Addendum C Addendum D Addendum E

Sales Supervisor/Manager

Date:

Forms Attached :

Customer Acknowledgement

Customer Seal & Signature :

23 May 2011