Dealer COD Application

Basic Information of Customer


Contact Information

Contact Name Tel No. Email Address
Primary Contact            
Contact to Receive Statements            
Contact to receive Quotes and Invoices            

Acknowledgement By Customer

The Customer agrees to have read and understood Actsys Terms and Conditions of Sale, as published on it’s website and that these, will govern all transactions between the Customer and Actsys (Pty) Ltd. The Customer agrees to check the Terms and Conditions of Sale periodically for changes that may have taken effect from date of posting on the Website.


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