Merchants Application Form

Business Structure *

Select a Business Structure Sole Trader / Practitioner Private / Public Company Societe Cooperative Partnership

Business Registration Name *

BRN No *

Business Registration Card *

Trade Name *

Company number [Certificate of Incorporation] *

Certificate of Incorporation

Are you VAT registered? Yes No

VAT No *

VAT Certificate *

Minutes of Resolution/Proceedings appointing authorised signatories

Extract of file/Particulars of file

Status de la societe

Rules for Cooperative

Partnership deed

Proxy in case where Trade license is under another's person name

Trading Address *

City *

ALBION AMAURY ARSENAL BAGATELLE BAIE DU CAP BAIE DU TOMBEAU BALACLAVA BAMBOUS BATIMARAIS BEAU BASSIN BEAU CLIMAT BEAU SONGES BEAU VALLON BEAUX SONGES BEL AIR BEL AIR RIVIERE SECHE BEL ETANG BELLE RIVE BELLE ROSE BELLE TERRE BELLE VUE MAUREL BELVEDERE BLACK RIVER BON ACCUEIL BONNE MERE BRAMSTHAN BRISEE VERDIERE BRITANNIA CAMP CHAPELEON CAMP DE MASQUE CAMP DE MASQUE PAVE CAMP DIABLE CAMP FOUQUEREAUX CAMP ITHIER CAMP THOREL CANDOS CANOT CAP MALHEUREUX CAROLINE CASCAVELLE CASSIS CASTEL CATHEDRAL CAUDAN CENTRAL FLACQ CENTRE DE FLACQ CHAMOUNY CHEMIN GRENIER CONGOMAH COROMANDEL COTTAGE CREVE COEUR CUREPIPE D'EPINAY DAGOTIERE DUBREUIL EAU COULEE EBENE EBENE CITY FLACQ FLACQ FLIC EN FLAC FLOREAL FOND DU SAC FORBACH FOREST SIDE GLEN PARK GOODLANDS GRAND BAIE GRAND BAIE GRAND BOIS GRAND BOIS GRAND GAUBE GRAND PORT GRANDE RETRAITE GRANDE RIVIERE NOIRE GRANDE RIVIERE SUD EST GRNW GROS BILLOT GROS CAILLOUX HELVETIA HENRIETTA HERMITAGE HIGHLANDS ISIDORE ROSE KENDRA L ESCALIER L'ESCALIER LA CITY TRIANON LA FLORA LA GAULETTE LA PRENEUSE LA ROSA LA TOUR KOENIG LA VIGIE LALLMATIE LAMITIE LAVENTURE LE HOCHET LONG MOUNTAIN LOWER DAGOTIERE LOWER VALE MAHEBOURG MARE D'ALBERT MARE D'AUSTRALIA MARE LA CHAUX MARE TABAC MEDINE MEDINE CAMP DE MASQUE MELROSE MESNIL MIDLANDS MOKA MOKA MONT CHOISY MONT IDA MONT ROCHES MONTAGNE BLANCHE MONTAGNE ORY MORCELLEMENT ST ANDRE NEW GROVE NOTRE DAME NOUVELLE DECOUVERTE NOUVELLE FRANCE OLIVIA PAILLES PAMPLEMOUSSES PEREYBERE PETIT RAFFRAY PETITE JULIE PETITE RIVIERE PHOENIX PITON PLAINE DES PAPAYES PLAINE DES ROCHES PLAINE LAUZUN PLAINE MAGNIEN PLAINE VERTE PLAINES DES PAPAYES PLAISANCE POINTE AUX CANONNIERS POINTE AUX PIMENTS POINTE AUX SABLES PORT LOUIS POSTE DE FLACQ POSTE LA FAYETTE POUDRE D'OR VILLAGE PROVIDENCE PTE AUX CANNONIERS QUARTIER MILITAIRE QUATRE BORNES QUATRE BORNES QUATRE COCOS QUATRE SOEURS REDUIT REDUIT RIAMBEL RICHE MARE RICHE TERRE RIVIERE DES ANGUILLES RIVIERE DU POSTE RIVIERE DU REMPART RIVIERE NOIRE ROCHE BOIS ROCHE TERRE ROCHES BRUNES ROCHES NOIRES RODRIGUES ROSE BELLE ROSE HILL ROSE HILL SAINT AUBIN SAINT HUBERT SAINT JULIEN SAINT JULIEN D'HOTMAN SAINT PAUL SAINT PIERRE SAINTE CROIX SEBASTOPOL SODNAC SOLITUDE SOUILLAC SURINAM TAMARIN TERRE ROUGE THE VALE TOMBEAU BAY TOMBEAU BAY TREFLES TRIANON TRIOLET TROIS BOUTIQUES TROU AUX BICHES TROU D'EAU DOUCE TYACK UNION PARK UPPER DAGOTIERE UPPER VALE VACOAS VALETTA VALLEE DES PRETRES VALLEE PITOT VERDUN

District *

BLACK RIVER FLACQ GRAND PORT MOKA PAMPLEMOUSSES PLAINES WILHEMS PORT LOUIS RIVIERE DU REMPART RODRIGUES SAVANNE

Categories *

MT Distributor

Cold Storage

Florist

FMCG Distributor

General Retailer

Hardware Store

Hawker / Market Trader

Stationery shop

Tabagie

Canteen

Snack / Fast Food

Food chain

Catering

Cafe / Restaurant

Food hawker

Bakery / Pastry

Accessories

Jewellers

Kids / Toys / Clothing

Handicrafts / Déco

Fashion outlet

Hair Salon / Beauty / Spa

Clinic / Hospital / Pharmacy

Doctors

Laboratory

Cleaning services / Car wash

Courier / Carrier

Education

Insurance

Online / apps

Parking

Transport

Government / NGOS

Auto / Spare parts / Workshop

Computer shop

Home appliances / Equipment

Mobile phone dealer

Hypermarket

Libre service

Supermarket

Petrol Station + Car wash

Petrol Station + Convenience stores

Petrol Station only

Hotel / Villa

Leisure parks

Production / Cinema

Pubs / Night club

Booking agency

Sports club / Gyms

Other services

Kindly specify *

Surname *

First Name *

Citizen of Mauritius * Yes No

National ID No *

Passport Number *

Upload National ID Card / Passport *

Upload National ID Card (Back side)

Mobile No *

Office No *

Email *

Job Title *

Bank Name *

ABC Banking ABSA Bank (Mauritius) Ltd Afrasia Bank Bank of Baroda Bank One Ltd BCP Bank (Mauritius) Ltd HSBC Mauritius MauBank Ltd Mauritius Commercial Bank SBI (Mauritius) Ltd SBM Bank (Mauritius) Ltd

Branch *

Bank Account No *

Proof of Bank account

Surname

Name

Mobile No.

Office No.

Job Title

Email address

Surname

Name

Mobile No.

Office No.

Job Title

Email address

Surname

Name

Mobile No.

Office No.

Job Title

Email address

Surname

Name

Mobile No.

Office No.

Job Title

Email address

Surname

Name

Mobile No.

Office No.

Job Title

Email address

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