A request to change
registration information, customs clearance
electronically access documents. Registration Document Control Registration No. .............................................. ..
Place ............................................. .............
date been ................................ ....................
............................ officer ........................
filed Registration Department Director-General through the registration and privilege
. Office / Bureau of Customs ................................ customs ..................................... me (Name entrepreneurs Thailand ............. Company. Perry Forman's. Manufacturing Effects Manufacturing (Thailand) ............................) Taxpayer Identification Number. __0505540001571_ __ __ __ __ __ (corporate and other) headquarters __ 0000 __ __ branch registered with the IRS __ __ __ identity card passport or Alien Registration Number __ __ __ __ __ __ __. __ __ __ __ __ __ (individual) I states. Wishes to approve the changes, as follows (a complete text that needs changing) . Operator name Thai................................................ .................................................. .................................................. ....... English................................................ .................................................. .................................................. ... The establishment The building is located at .......................... ................... .................... Lane / Road ........................... ............. among the street .......... ................................................District/ District ............................... County / District ........................................ Province ...... ............................................... Postal Code Phone .................. ............................. ................................... fax ................................. E-mail ............... .. ..................... ......... ........... Bank canceled For the purpose of obtaining tax payment For the purpose of obtaining tax refund ........... Bangkok Bank. ........... Branch office ........... .................................... ...... deposits Current Account Savings ................................ .................................................. ............ Bank more For the purpose of obtaining tax payment to request a refund of duty in Thailand Commercial Bank ............. Ltd .. (S) ........ Lamphun branch .......... (Pa Heo) ........................................... account. savings deposits, current account No. 5843013335 ....................... .......... cancel the profile . Mr. Mrs. Ms. Name ............................................ ........ Currency ................................................. ....... identity card, passport, alien registration certificate __ __ __ __ __ __ No __ __ __ __ __ __ __ of additional revenue Mr. Mrs. Ms. name ............ ........................................ Currency ................................................. ....... identity card, passport, alien registration certificate __ __ __ __ __ __ No __ __ __ __ __ __ __ authorized to act on behalf of the I canceled her profile Mr Ms. name ... ................................................. Currency ................................................. ....... identity card, passport, alien registration certificate __ __ __ __ __ __ No __ __ __ __ __ __ __ authorized to act on behalf of the me more money Mr. Mrs. Ms. name ... ................................................. Currency ................................................. ....... ID cards passport or Alien Registration Number __ __ __ __ __ __ __ __ __ __ __ __ __ Brokerage importer - exporter staff / employee employee / employees who perform States. subcontractor canceled Taxpayer Identification Number __ __ __ __ __ __ __ __ __ __ (entity or person for VAT) Mr. Mrs. Ms. name ........... ................................ Currency ................................................. ..... (individuals) representative of the importer - exporter staff / employee employee / employees who perform the subcontractors more Taxpayer Identification Number __ __ __ __ __. __ (entity or person for VAT) Mr. Mrs. Ms. Name ................................. .......... Currency ................................................. ..... (individuals) Attorney's request for reimbursement of duties for exports canceled her profile Mr Ms. name ........................... ......................... Currency ................................................. ...... ID cards passport or Alien Registration Number __ __ __ __ __ __ __ __ __ __ __ __ __ attorney's request for reimbursement of duties for exports additional revenue Mr. Mrs Miss title. .................................................. .. Currency ................................................. ....... identity card, passport, alien registration number __ __ __ __ __ __ __ __ __ __ __ __ __ I hereby certify that the items listed above as completely accurate in all respects. And to approve the change registration information to clear customs to sign ................................... ...................................... The owner / manager (Mr. Patrick Matthew Blair and Mr Alan Peter's visit ... ....) filed on ..................... ................................ officer for the officer ............. .................................................. ............................. Signed .................... ............................... Officer (............................................) days. .................................................. ..... statement approved since ................................. Onwards disapproval sign ............................................ ....... authorized signatory (..................................... .........) ...................................... Date ................
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