{"id":10222,"date":"2019-11-26T10:25:41","date_gmt":"2019-11-26T02:25:41","guid":{"rendered":"https:\/\/www.zuppa.com.my\/zuppamarket\/?page_id=10222"},"modified":"2020-07-22T10:23:35","modified_gmt":"2020-07-22T02:23:35","slug":"corporate-account-application","status":"publish","type":"page","link":"https:\/\/www.zuppa.com.my\/zuppamarket\/corporate-account-application\/","title":{"rendered":"Corporate Account Registration"},"content":{"rendered":"<div id=\"erf_form_container_9865\" class=\"erf-container erf-contact erf-label-top erf-layout-one-column erf-style-rounded-corner\">\n        \n    \n         \n                    <div class=\"erf-content-above\">\n                Contact us by filling out the form below.            <\/div>\n            <form method=\"post\" enctype=\"multipart\/form-data\" class=\"erf-form erf-front-form\" data-parsley-validate=\"\" novalidate=\"true\" data-erf-submission-id=\"0\" data-erf-form-id=\"9865\">\n                <div class=\"erf-form-html\" id=\"erf_form_9865\">\n                    <div class=\"rendered-form\">\n                        <div class=\"erf-header erf-element-width-12\"><h1  data-non-input='1' data-ref-label='ref-CoDuSWNb' data-ref-id='ref-BgMDJNS7' class='' >ZUPPA CORPORATE ACCOUNT APPLICATION<\/h1><\/div><div class=\"erf-header erf-element-width-12\"><h2  data-non-input='1' data-ref-label='ref-P6WMxjR9' data-ref-id='ref-vT9Z9SIC' class='' >[A] COMPANY INFORMATION<\/h2><\/div><div class=\"erf-text form-group field-field-2VQljG1jVRXxQKD erf-element-width-12\"><label for=\"field-2VQljG1jVRXxQKD\" class=\"erf-text-label\">Company Name<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-2VQljG1jVRXxQKD' required='required' data-ref-label='Company_Name' id='field-2VQljG1jVRXxQKD'  \/><\/div><div class=\"erf-checkbox-group form-group field-field-7S1JDHSzGO9jFOl erf-element-width-12\"><label for=\"field-7S1JDHSzGO9jFOl\" class=\"erf-checkbox-group-label\">Operation Days<span class=\"erf-required\">*<\/span><\/label><div class=\"checkbox-group\"><div class=\"checkbox\"><input id=\"field-7S1JDHSzGO9jFOl-0\" name='field-7S1JDHSzGO9jFOl[]' data-ref-label='Checkbox_Group1' required='required' class='form-control' multiple='1'  type=\"checkbox\" value=\"Value\" \/><label for=\"field-7S1JDHSzGO9jFOl-0\">Monday<\/label><\/div><div class=\"checkbox\"><input id=\"field-7S1JDHSzGO9jFOl-1\" name='field-7S1JDHSzGO9jFOl[]' data-ref-label='Checkbox_Group1' required='required' class='form-control' multiple='1'  type=\"checkbox\" value=\"Value\" \/><label for=\"field-7S1JDHSzGO9jFOl-1\">Tuesday<\/label><\/div><div class=\"checkbox\"><input id=\"field-7S1JDHSzGO9jFOl-2\" name='field-7S1JDHSzGO9jFOl[]' data-ref-label='Checkbox_Group1' required='required' class='form-control' multiple='1'  type=\"checkbox\" value=\"Value\" \/><label for=\"field-7S1JDHSzGO9jFOl-2\">Wednesday<\/label><\/div><div class=\"checkbox\"><input id=\"field-7S1JDHSzGO9jFOl-3\" name='field-7S1JDHSzGO9jFOl[]' data-ref-label='Checkbox_Group1' required='required' class='form-control' multiple='1'  type=\"checkbox\" value=\"Value\" \/><label for=\"field-7S1JDHSzGO9jFOl-3\">Thursday<\/label><\/div><div class=\"checkbox\"><input id=\"field-7S1JDHSzGO9jFOl-4\" name='field-7S1JDHSzGO9jFOl[]' data-ref-label='Checkbox_Group1' required='required' class='form-control' multiple='1'  type=\"checkbox\" value=\"Value\" \/><label for=\"field-7S1JDHSzGO9jFOl-4\">Friday<\/label><\/div><div class=\"checkbox\"><input id=\"field-7S1JDHSzGO9jFOl-5\" name='field-7S1JDHSzGO9jFOl[]' data-ref-label='Checkbox_Group1' required='required' class='form-control' multiple='1'  type=\"checkbox\" value=\"Value\" \/><label for=\"field-7S1JDHSzGO9jFOl-5\">Saturday<\/label><\/div><\/div><\/div><div class=\"erf-number form-group field-field-cxkloU57jAFQDhO erf-element-width-12\"><label for=\"field-cxkloU57jAFQDhO\" class=\"erf-number-label\">Number of Employee<span class=\"erf-required\">*<\/span><\/label><input type='number' data-ref-label='Number2' class='form-control' name='field-cxkloU57jAFQDhO' required='required' id='field-cxkloU57jAFQDhO'  \/><\/div><div class=\"erf-text form-group field-field-N6cbEv318dxTQP9 erf-element-width-12\"><label for=\"field-N6cbEv318dxTQP9\" class=\"erf-text-label\">Nature of Business<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='Text_Field18' class='form-control' name='field-N6cbEv318dxTQP9' required='required' id='field-N6cbEv318dxTQP9'  \/><\/div><div class=\"erf-text form-group field-field-Qk1lrFFE067Rc3c erf-element-width-12\"><label for=\"field-Qk1lrFFE067Rc3c\" class=\"erf-text-label\">Company Website<\/label><input type='text' data-ref-label='Text_Field17' class='form-control' name='field-Qk1lrFFE067Rc3c' id='field-Qk1lrFFE067Rc3c'  \/><\/div><div class=\"erf-splitter erf-element-width-12\"><div data-non-input='1' custom-type='page-break' data-ref-label='Splitter7' class='' data-ref-id='splitter-rorswr4w' >Splitter7<\/div><\/div><div class=\"erf-header erf-element-width-12\"><h1  data-non-input='1' data-ref-label='Heading8' data-ref-id='header-2ube2ydj' class='' >[B] BUSINESS REGISTRATION INFORMATION<\/h1><\/div><div class=\"erf-text form-group field-field-XZoBHLuhabWQdif erf-element-width-6\"><label for=\"field-XZoBHLuhabWQdif\" class=\"erf-text-label\">Date of Incorporation<span class=\"erf-required\">*<\/span><\/label><input type='text' data-date-format='mm\/dd\/yy' class='form-control erf-date-field' name='field-XZoBHLuhabWQdif' required='required' data-ref-label='Date_of_Incorporation' id='field-XZoBHLuhabWQdif'  \/><\/div><div class=\"erf-text form-group field-field-D2IKMUM7t6W2eVd erf-element-width-6\"><label for=\"field-D2IKMUM7t6W2eVd\" class=\"erf-text-label\">Business Registration No. (Old)<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-D2IKMUM7t6W2eVd' required='required' data-ref-label='Business_Registration_No' id='field-D2IKMUM7t6W2eVd'  \/><\/div><div class=\"erf-text form-group field-field-oyBNkR2eIc1oT6Y erf-element-width-12\"><label for=\"field-oyBNkR2eIc1oT6Y\" class=\"erf-text-label\">Business Registration No. (New)<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='Text_Field15' class='form-control' name='field-oyBNkR2eIc1oT6Y' required='required' id='field-oyBNkR2eIc1oT6Y'  \/><\/div><div class=\"erf-text form-group field-field-jamGJWrSuiB0K1y erf-element-width-12\"><label for=\"field-jamGJWrSuiB0K1y\" class=\"erf-text-label\">Tax Identification No. (TIN)<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='Text_Field16' class='form-control' name='field-jamGJWrSuiB0K1y' required='required' id='field-jamGJWrSuiB0K1y'  \/><\/div><div class=\"erf-number form-group field-field-oYtwYxXUkZuucAc erf-element-width-12\"><label for=\"field-oYtwYxXUkZuucAc\" class=\"erf-number-label\">MSIC Code<span class=\"erf-required\">*<\/span><\/label><input type='number' data-ref-label='Number3' class='form-control' name='field-oYtwYxXUkZuucAc' required='required' id='field-oYtwYxXUkZuucAc'  \/><\/div><div class=\"erf-number form-group field-field-nwBFonxoRIJucjO erf-element-width-12\"><label for=\"field-nwBFonxoRIJucjO\" class=\"erf-number-label\">Authorised Capital RM<span class=\"erf-required\">*<\/span><\/label><input type='number' data-ref-label='Number4' class='form-control' name='field-nwBFonxoRIJucjO' required='required' id='field-nwBFonxoRIJucjO'  \/><\/div><div class=\"erf-number form-group field-field-HqiGbSVGumLDNxL erf-element-width-12\"><label for=\"field-HqiGbSVGumLDNxL\" class=\"erf-number-label\">Paid-up Capital RM<span class=\"erf-required\">*<\/span><\/label><input type='number' data-ref-label='Number6' class='form-control' name='field-HqiGbSVGumLDNxL' required='required' id='field-HqiGbSVGumLDNxL'  \/><\/div><div class=\"erf-splitter erf-element-width-12\"><div data-non-input='1' custom-type='page-break' data-ref-label='Splitter6' class='' data-ref-id='splitter-qhibg29s' >Splitter6<\/div><\/div><div class=\"erf-header erf-element-width-12\"><h1  data-non-input='1' data-ref-label='Heading9' data-ref-id='header-ndxapzow' class='' >[C} BANK REFERENCE DETAILS<\/h1><\/div><div class=\"erf-text form-group field-field-iT6ACOYpUXIPLlU erf-element-width-12\"><label for=\"field-iT6ACOYpUXIPLlU\" class=\"erf-text-label\">Name of Bank<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='Text_Field20' class='form-control' name='field-iT6ACOYpUXIPLlU' required='required' id='field-iT6ACOYpUXIPLlU'  \/><\/div><div class=\"erf-number form-group field-field-wqKDK9ID0B717Kr erf-element-width-12\"><label for=\"field-wqKDK9ID0B717Kr\" class=\"erf-number-label\">Bank Account No.<span class=\"erf-required\">*<\/span><\/label><input type='number' data-ref-label='Number5' class='form-control' name='field-wqKDK9ID0B717Kr' required='required' id='field-wqKDK9ID0B717Kr'  \/><\/div><div class=\"erf-text form-group field-field-CWyLwD1TtTLMvoD erf-element-width-12\"><label for=\"field-CWyLwD1TtTLMvoD\" class=\"erf-text-label\">Bank Branch<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='Text_Field19' class='form-control' name='field-CWyLwD1TtTLMvoD' required='required' id='field-CWyLwD1TtTLMvoD'  \/><\/div><div class=\"erf-splitter erf-element-width-12\"><div data-non-input='1' custom-type='page-break' class='' data-ref-label='ref-CIlelLGi' data-ref-id='ref-ISNDaJOJ' >Splitter<\/div><\/div><div class=\"erf-header erf-element-width-12\"><h2  data-non-input='1' data-ref-label='ref-Ad8aSj0S' data-ref-id='ref-d6CsN0gb' class='' >[D] PROCUREMENT\/ REQUESTOR'S DETAILS<\/h2><\/div><div class=\"erf-text form-group field-text-55683293821 erf-element-width-12\"><label for=\"text-55683293821\" class=\"erf-text-label\">First Name<span class=\"erf-required\">*<\/span><\/label><input type='text' maxlength='50' required='required' class='form-control' name='text-55683293821' data-ref-label='First_Name' id='text-55683293821'  \/><\/div><div class=\"erf-text form-group field-text-210719472255 erf-element-width-12\"><label for=\"text-210719472255\" class=\"erf-text-label\">Last Name<span class=\"erf-required\">*<\/span><\/label><input type='text' required='required' maxlength='50' class='form-control' name='text-210719472255' data-ref-label='Last_Name' id='text-210719472255'  \/><\/div><div class=\"erf-text form-group field-field-KIaMElo0KEpzA2w erf-element-width-12\"><label for=\"field-KIaMElo0KEpzA2w\" class=\"erf-text-label\">Designation<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-KIaMElo0KEpzA2w' required='required' data-ref-label='Designation' id='field-KIaMElo0KEpzA2w'  \/><\/div><div class=\"erf-email form-group field-text-23284638358 erf-element-width-12\"><label for=\"text-23284638358\" class=\"erf-email-label\">Email Address<span class=\"erf-required\">*<\/span><\/label><input type='email' required='required' class='form-control' name='text-23284638358' data-ref-label='Email' id='text-23284638358'  \/><\/div><div class=\"erf-tel form-group field-field-w7LMVJPHqPvwrL1 erf-element-width-6\"><label for=\"field-w7LMVJPHqPvwrL1\" class=\"erf-tel-label\">Office Phone<span class=\"erf-required\">*<\/span><\/label><input type='tel' class='form-control' name='field-w7LMVJPHqPvwrL1' required='required' enable-intl='1' data-ref-label='Office_Phone' id='field-w7LMVJPHqPvwrL1'  \/><\/div><div class=\"erf-tel form-group field-field-nJYW7HzGKZ1wZQo erf-element-width-6\"><label for=\"field-nJYW7HzGKZ1wZQo\" class=\"erf-tel-label\">Mobile Phone<span class=\"erf-required\">*<\/span><\/label><input type='tel' class='form-control' name='field-nJYW7HzGKZ1wZQo' required='required' enable-intl='1' data-ref-label='Mobile_Phone' id='field-nJYW7HzGKZ1wZQo'  \/><\/div><div class=\"erf-splitter erf-element-width-12\"><div data-non-input='1' custom-type='page-break' class='' data-ref-label='ref-gvn04b4B' data-ref-id='ref-aj4sCpOL' >Splitter<\/div><\/div><div class=\"erf-header erf-element-width-12\"><h2  data-non-input='1' data-ref-label='ref-7XHntmkJ' data-ref-id='ref-Kpq3qMHg' class='' >[E] BILLING DETAILS<\/h2><\/div><div class=\"erf-text form-group field-field-2GcrwdCLKHg1cMD erf-element-width-12\"><label for=\"field-2GcrwdCLKHg1cMD\" class=\"erf-text-label\">Company\/ Entity Name<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-2GcrwdCLKHg1cMD' required='required' data-ref-label='Company_Entity_Name' id='field-2GcrwdCLKHg1cMD'  \/><\/div><div class=\"erf-street1 form-group field-field-7u5HvtMQ8qbrnrC erf-element-width-12\"><label for=\"field-7u5HvtMQ8qbrnrC\" class=\"erf-street1-label\">Street Address1<span class=\"erf-required\">*<\/span><\/label><input type='street1' class='form-control' name='field-7u5HvtMQ8qbrnrC' placeholder='Unit\/Level\/Building Name' required='required' data-ref-label='Street_Address1' id='field-7u5HvtMQ8qbrnrC'  \/><\/div><div class=\"erf-street2 form-group field-field-tlMiSyBFa6VR6UH erf-element-width-12\"><label for=\"field-tlMiSyBFa6VR6UH\" class=\"erf-street2-label\">Street Address2<span class=\"erf-required\">*<\/span><\/label><input type='street2' class='form-control' name='field-tlMiSyBFa6VR6UH' placeholder='Street Name' required='required' data-ref-label='Street_Address2' id='field-tlMiSyBFa6VR6UH'  \/><\/div><div class=\"erf-select form-group field-field-oCUQBmk0VbKvBL9 erf-element-width-12\"><label for=\"field-oCUQBmk0VbKvBL9\" class=\"erf-country-label\">Country<span class=\"erf-required\">*<\/span><\/label><select class='form-control' name='field-oCUQBmk0VbKvBL9' required='required' data-ref-label='Country' id='field-oCUQBmk0VbKvBL9'  ><\/select><\/div><div class=\"erf-select form-group field-field-vphMQDPC2Q9FCKw erf-element-width-12\"><label for=\"field-vphMQDPC2Q9FCKw\" class=\"erf-state-label\">State \/ Province<span class=\"erf-required\">*<\/span><\/label><select class='form-control' name='field-vphMQDPC2Q9FCKw' required='required' data-ref-label='State__Province' id='field-vphMQDPC2Q9FCKw'  ><\/select><\/div><div class=\"erf-city form-group field-field-PrPFOOYSLzXaDMY erf-element-width-12\"><label for=\"field-PrPFOOYSLzXaDMY\" class=\"erf-city-label\">City<span class=\"erf-required\">*<\/span><\/label><input type='city' class='form-control' name='field-PrPFOOYSLzXaDMY' required='required' data-ref-label='City' id='field-PrPFOOYSLzXaDMY'  \/><\/div><div class=\"erf-zip form-group field-field-pE9YIDe3VJFUMFT erf-element-width-12\"><label for=\"field-pE9YIDe3VJFUMFT\" class=\"erf-zip-label\">Postcode \/ Zip<span class=\"erf-required\">*<\/span><\/label><input type='zip' class='form-control' name='field-pE9YIDe3VJFUMFT' required='required' data-ref-label='Postcode__Zip' id='field-pE9YIDe3VJFUMFT'  \/><\/div><div class=\"erf-splitter erf-element-width-12\"><div data-non-input='1' custom-type='page-break' class='' data-ref-label='ref-osaUEpl7' data-ref-id='ref-oZEYlzED' >Splitter<\/div><\/div><div class=\"erf-header erf-element-width-12\"><h2  data-non-input='1' data-ref-label='ref-EaXt3uQi' data-ref-id='ref-K4phFjjz' class='' >[F]  INVOICE SUBMISSION | IMPORTANT : Only email addresses input in this section will receive invoices<\/h2><\/div><div class=\"erf-text form-group field-field-OFoKRWiaDsfa6bJ erf-element-width-6\"><label for=\"field-OFoKRWiaDsfa6bJ\" class=\"erf-text-label\">Finance\/AP PIC First Name<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-OFoKRWiaDsfa6bJ' required='required' data-ref-label='FinanceAP_PIC_First_Name' id='field-OFoKRWiaDsfa6bJ'  \/><\/div><div class=\"erf-text form-group field-field-OTp1AG7C28zz2M8 erf-element-width-6\"><label for=\"field-OTp1AG7C28zz2M8\" class=\"erf-text-label\">Finance\/AP PIC Last Name<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-OTp1AG7C28zz2M8' required='required' data-ref-label='FinanceAP_PIC_Last_Name' id='field-OTp1AG7C28zz2M8'  \/><\/div><div class=\"erf-tel form-group field-field-6Q91SP3my5SOa4S erf-element-width-6\"><label for=\"field-6Q91SP3my5SOa4S\" class=\"erf-tel-label\">Direct Phone<span class=\"erf-required\">*<\/span><\/label><input type='tel' class='form-control' name='field-6Q91SP3my5SOa4S' required='required' enable-intl='1' data-ref-label='Phone' id='field-6Q91SP3my5SOa4S'  \/><\/div><div class=\"erf-email form-group field-field-FneNcEcDFbmQIfD erf-element-width-6\"><label for=\"field-FneNcEcDFbmQIfD\" class=\"erf-email-label\">Finance\/AP PIC's Email<span class=\"erf-required\">*<\/span><\/label><input type='email' class='form-control' name='field-FneNcEcDFbmQIfD' required='required' data-ref-label='FinanceAP_PICs_Email' id='field-FneNcEcDFbmQIfD'  \/><\/div><div class=\"erf-email form-group field-field-bm97R8myU8wQm8D erf-element-width-12\"><label for=\"field-bm97R8myU8wQm8D\" class=\"erf-email-label\">Email to Receive Invoice<span class=\"erf-required\">*<\/span><span class=\"tooltip-element\" tooltip=\"Soft copy invoice will be sent to this email after delivery\"><i class=\"fa fa-info\" aria-hidden=\"true\"><\/i><\/span><\/label><input type='email' class='form-control' name='field-bm97R8myU8wQm8D' required='required' data-ref-label='Email_to_Receive_Invoice' id='field-bm97R8myU8wQm8D'  \/><\/div><div class=\"erf-email form-group field-field-DtgGLlWRBA0AYHz erf-element-width-12\"><label for=\"field-DtgGLlWRBA0AYHz\" class=\"erf-email-label\">Email 2 to Receive Invoice<\/label><input type='email' data-ref-label='Email6' class='form-control' name='field-DtgGLlWRBA0AYHz' id='field-DtgGLlWRBA0AYHz'  \/><\/div><div class=\"erf-email form-group field-field-aIQzydmBTaM92vy erf-element-width-12\"><label for=\"field-aIQzydmBTaM92vy\" class=\"erf-email-label\">Email 3 to Receive Invoice<\/label><input type='email' data-ref-label='Email7' class='form-control' name='field-aIQzydmBTaM92vy' id='field-aIQzydmBTaM92vy'  \/><\/div><div class=\"erf-splitter erf-element-width-12\"><div data-non-input='1' custom-type='page-break' class='' data-ref-label='ref-9QZ1pwAf' data-ref-id='ref-cRHhu0x3' >Splitter<\/div><\/div><div class=\"erf-header erf-element-width-12\"><h2  data-non-input='1' data-ref-label='ref-lhx69zbe' data-ref-id='ref-YgNXlvVM' class='' >[G] REQUIRED SUPPORTING DOCUMENT<\/h2><\/div><div class=\"erf-richtext erf-element-width-12\"><div data-non-input='1' data-ref-label='SSM Profle Sample' data-ref-id='richtext-gjju3dff' class='erf-rich-text' ><p><a href=\"https:\/\/www.zuppa.com.my\/zuppamarket\/wp-content\/uploads\/Sample-SSM-Company-Profile.pdf\">Download SSM Profile sample<\/a><\/p><\/div><\/div><div class=\"erf-file form-group field-field-1ygrp7yTmLld5jz erf-element-width-12\"><label for=\"field-1ygrp7yTmLld5jz\" class=\"erf-file-label\">SSM Company Profile (Previously known as Form 9, 24 and 49)<span class=\"erf-required\">*<\/span><span class=\"tooltip-element\" tooltip=\"Upload here your company SSM profile\/Form 9\/24\/49. See sample SSM Profile by downloading from URL provided above.\"><i class=\"fa fa-info\" aria-hidden=\"true\"><\/i><\/span><\/label><input type='file' class='form-control' name='field-1ygrp7yTmLld5jz' required='required' data-ref-label='SSM_Company_Profile_Previously_known_as_' id='field-1ygrp7yTmLld5jz'  \/><\/div><div class=\"erf-separator erf-element-width-12\"><div data-non-input='1' custom-type='spacer' data-ref-label='Separator1' class='spacer' data-ref-id='separator-qdfjubzy' >Separator1<\/div><\/div><div class=\"erf-richtext erf-element-width-12\"><div data-non-input='1' data-ref-label='Zuppa Corporate Account Application Form' data-ref-id='richtext-0sfykbmd' class='erf-rich-text' ><p><a href=\"https:\/\/www.zuppa.com.my\/zuppamarket\/wp-content\/uploads\/ZM_Zuppa-Corporate-Account-Application-Form_v9_Section2-TC-Declaration.pdf\">Download Zuppa Corporate Account Application Form<\/a><\/p><\/div><\/div><div class=\"erf-file form-group field-field-3Ur50NDqaORnIg0 erf-element-width-12\"><label for=\"field-3Ur50NDqaORnIg0\" class=\"erf-file-label\">Zuppa Corporate Account T&C<span class=\"erf-required\">*<\/span><span class=\"tooltip-element\" tooltip=\"Upload here your the completed form (signed and complete with company stamp).\"><i class=\"fa fa-info\" aria-hidden=\"true\"><\/i><\/span><\/label><input type='file' class='form-control' name='field-3Ur50NDqaORnIg0' required='required' data-ref-label='Zuppa_Corporate_Account_TC' id='field-3Ur50NDqaORnIg0'  \/><\/div><div class=\"erf-separator erf-element-width-12\"><div data-non-input='1' custom-type='spacer' data-ref-label='Separator2' class='spacer' data-ref-id='separator-czzuvdbj' >Separator2<\/div><\/div><div class=\"erf-file form-group field-field-9gSf2GfxdwDxtwh erf-element-width-12\"><label for=\"field-9gSf2GfxdwDxtwh\" class=\"erf-file-label\">Bank Statement Header<span class=\"erf-required\">*<\/span><\/label><input type='file' data-ref-label='File_Upload3' class='form-control' name='field-9gSf2GfxdwDxtwh' required='required' id='field-9gSf2GfxdwDxtwh'  \/><\/div><div class=\"erf-splitter erf-element-width-12\"><div data-non-input='1' custom-type='page-break' data-ref-label='Splitter8' class='' data-ref-id='splitter-xet2nn4x' >Splitter8<\/div><\/div><div class=\"erf-header erf-element-width-12\"><h2  data-non-input='1' data-ref-label='ref-sBRnHWE4' data-ref-id='ref-a5xsRT1n' class='' >[H] SHIPPING DETAILS<\/h2><\/div><div class=\"erf-text form-group field-field-3TuyRMEFlBkP7id erf-element-width-6\"><label for=\"field-3TuyRMEFlBkP7id\" class=\"erf-text-label\">Recipient's First Name<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-3TuyRMEFlBkP7id' required='required' data-ref-label='Recipients_First_Name' id='field-3TuyRMEFlBkP7id'  \/><\/div><div class=\"erf-text form-group field-field-l4BwiimAdzMR8uF erf-element-width-6\"><label for=\"field-l4BwiimAdzMR8uF\" class=\"erf-text-label\">Recipient's Last Name<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-l4BwiimAdzMR8uF' required='required' data-ref-label='Recipients_Last_Name' id='field-l4BwiimAdzMR8uF'  \/><\/div><div class=\"erf-tel form-group field-field-UVdWXSEPPtDjJk8 erf-element-width-6\"><label for=\"field-UVdWXSEPPtDjJk8\" class=\"erf-tel-label\">Recipient's Mobile Phone<span class=\"erf-required\">*<\/span><\/label><input type='tel' class='form-control' name='field-UVdWXSEPPtDjJk8' required='required' enable-intl='1' data-ref-label='Recipients_Mobile_Phone' id='field-UVdWXSEPPtDjJk8'  \/><\/div><div class=\"erf-email form-group field-field-bc6aWuFcDWD8HWQ erf-element-width-6\"><label for=\"field-bc6aWuFcDWD8HWQ\" class=\"erf-email-label\">Recipient's Email<span class=\"erf-required\">*<\/span><\/label><input type='email' class='form-control' name='field-bc6aWuFcDWD8HWQ' required='required' data-ref-label='Recipients_Email' id='field-bc6aWuFcDWD8HWQ'  \/><\/div><div class=\"erf-text form-group field-field-l2zGH9nMldB3uIw erf-element-width-6\"><label for=\"field-l2zGH9nMldB3uIw\" class=\"erf-text-label\">(Alternative) Recipient's First Name<\/label><input type='text' class='form-control' name='field-l2zGH9nMldB3uIw' data-ref-label='Alternative_Recipients_First_Name' id='field-l2zGH9nMldB3uIw'  \/><\/div><div class=\"erf-text form-group field-field-M0HuAUiZJqbkktD erf-element-width-6\"><label for=\"field-M0HuAUiZJqbkktD\" class=\"erf-text-label\">(Alternative) Recipient's Last Name<\/label><input type='text' class='form-control' name='field-M0HuAUiZJqbkktD' data-ref-label='Alternative_Recipients_Last_Name' id='field-M0HuAUiZJqbkktD'  \/><\/div><div class=\"erf-tel form-group field-field-N9GLPU5bXgakijZ erf-element-width-6\"><label for=\"field-N9GLPU5bXgakijZ\" class=\"erf-tel-label\">(Alternative) Recipient's Mobile Number<\/label><input type='tel' class='form-control' name='field-N9GLPU5bXgakijZ' enable-intl='1' data-ref-label='Alternative_Recipients_Mobile_Number' id='field-N9GLPU5bXgakijZ'  \/><\/div><div class=\"erf-email form-group field-field-PjdrAv5vgKchFgj erf-element-width-6\"><label for=\"field-PjdrAv5vgKchFgj\" class=\"erf-email-label\">(Alternative) Recipient's Email<\/label><input type='email' class='form-control' name='field-PjdrAv5vgKchFgj' data-ref-label='Alternative_Recipients_Email' id='field-PjdrAv5vgKchFgj'  \/><\/div><div class=\"erf-text form-group field-field-LM0pG3hidectfDE erf-element-width-12\"><label for=\"field-LM0pG3hidectfDE\" class=\"erf-text-label\">Company\/ Entity Name<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-LM0pG3hidectfDE' required='required' data-ref-label='Company_Entity_Name_2' id='field-LM0pG3hidectfDE'  \/><\/div><div class=\"erf-street1 form-group field-field-wfbCa3oL6aExwic erf-element-width-12\"><label for=\"field-wfbCa3oL6aExwic\" class=\"erf-street1-label\">Street Address1<span class=\"erf-required\">*<\/span><\/label><input type='street1' class='form-control' name='field-wfbCa3oL6aExwic' placeholder='Unit\/Level\/Building Name' required='required' data-ref-label='Street_Address1_2' id='field-wfbCa3oL6aExwic'  \/><\/div><div class=\"erf-street2 form-group field-field-jutJbTbPzC1kcc9 erf-element-width-12\"><label for=\"field-jutJbTbPzC1kcc9\" class=\"erf-street2-label\">Street Address2<span class=\"erf-required\">*<\/span><\/label><input type='street2' class='form-control' name='field-jutJbTbPzC1kcc9' placeholder='Street Name' required='required' data-ref-label='Street_Address2_2' id='field-jutJbTbPzC1kcc9'  \/><\/div><div class=\"erf-city form-group field-field-NdVMMO4cO660Dku erf-element-width-12\"><label for=\"field-NdVMMO4cO660Dku\" class=\"erf-city-label\">City<span class=\"erf-required\">*<\/span><\/label><input type='city' class='form-control' name='field-NdVMMO4cO660Dku' required='required' data-ref-label='City_2' id='field-NdVMMO4cO660Dku'  \/><\/div><div class=\"erf-zip form-group field-field-pwqLpYyKVl1A5s2 erf-element-width-6\"><label for=\"field-pwqLpYyKVl1A5s2\" class=\"erf-zip-label\">Postcode<span class=\"erf-required\">*<\/span><\/label><input type='zip' class='form-control' name='field-pwqLpYyKVl1A5s2' required='required' data-ref-label='Postcode' id='field-pwqLpYyKVl1A5s2'  \/><\/div><div class=\"erf-select form-group field-field-iU7TU7GXg96mbC8 erf-element-width-6\"><label for=\"field-iU7TU7GXg96mbC8\" class=\"erf-select-label\">State<span class=\"erf-required\">*<\/span><\/label><select class='form-control' name='field-iU7TU7GXg96mbC8' required='required' data-ref-label='State' id='field-iU7TU7GXg96mbC8'  ><option value=\"Value\">Selangor<\/option><option value=\"Value\">Wilayah Persekutuan KL<\/option><option value=\"Value\">Wilayah Persekutuan Putrajaya<\/option><option value=\"Value\">Johor<\/option><option value=\"Value\">Kedah<\/option><option value=\"Value\">Kelantan<\/option><option value=\"Value\">Melaka<\/option><option value=\"Value\">Negeri Sembilan<\/option><option value=\"Value\">Penang<\/option><option value=\"Value\">Perak<\/option><option value=\"Value\">Perlis<\/option><option value=\"Value\">Terengganu<\/option><option value=\"Value\">Sabah<\/option><option value=\"Value\">Sarawak<\/option><option value=\"Value\">Wilayah Persekutuan Labuan<\/option><\/select><\/div><div class=\"erf-select form-group field-field-pWQLrgAw1PkqyRd erf-element-width-12\"><label for=\"field-pWQLrgAw1PkqyRd\" class=\"erf-country-label\">Country<span class=\"erf-required\">*<\/span><\/label><select data-ref-label='Country2' class='form-control' name='field-pWQLrgAw1PkqyRd' required='required' id='field-pWQLrgAw1PkqyRd'  ><\/select><\/div><div class=\"erf-splitter erf-element-width-12\"><div data-non-input='1' custom-type='page-break' class='' data-ref-label='ref-7RNm2Fxg' data-ref-id='ref-JBwa61Kf' >Splitter<\/div><\/div><div class=\"erf-button form-group field-button-14767628952 erf-element-width-12\"><button type='submit'class='btn btn-default'name='button-14767628952'data-ref-label='Send'id='button-14767628952'>Send<\/button><\/div>                    <\/div> \n                <\/div>    \n\n                <div class=\"erf-external-form-elements\">\n                    \n                    \n                    \n\n                    \n                                        <div class=\"erf-errors\" style=\"display:none\">\n                        <span class=\"erf-errors-head erf-error-row\">Error occured. Please confirm your data and submit again:<\/span>\n                        <div class=\"erf-errors-body\">\n                                                    <\/div> \n                    <\/div>\n\n                <\/div>\n                <!-- Contains multipage Next,Previous buttons -->\n                <div class=\"erf-form-nav clearfix\"><\/div> \n\n                <!-- Single page form button -->\n                <div class=\"erf-submit-button clearfix\"><\/div>\n\n\n                <input type=\"hidden\" name=\"erform_id\" value=\"9865\" \/>\n                <input type=\"hidden\" id=\"erform_submission_nonce\" name=\"erform_submission_nonce\" value=\"a186e4eee1\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/zuppamarket\/wp-json\/wp\/v2\/pages\/10222\" \/>                <input type=\"hidden\" name=\"action\" value=\"erf_submit_form\" \/>\n\n            <\/form>\n            \n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":34,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v17.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Corporate Account Registration<\/title>\n<meta name=\"description\" content=\"For bulk contractual pantry items purchases. Place your orders with purchase order (PO). Contact us for more details.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.zuppa.com.my\/zuppamarket\/corporate-account-application\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Corporate Account Registration\" \/>\n<meta property=\"og:description\" content=\"For bulk contractual pantry items purchases. Place your orders with purchase order (PO). 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