Deliverex Domestic And Logistic shipping

Company Legal Name*

Company Trading Name*

Company Registration Number*

Company Registration Certificate/Trade License*

Tax/VAT Registration Number

Tax/VAT Registration Certificate

How did you hear about Deliverex?*

Tax/VAT Exemption Yes No

City*

Postal Code*

Street*

Phone Number*

Title Mr. Mrs.

First Name*

Last Name*

Email*

Phone Number*

City*

Postal Code*

Street*

Authorized Person Email ID*

Password*

Confirm Password*