NEW VENDOR REQUEST FORM

PFIZER (M) SDN BHD

Level 3 & 4, Bangunan Palm Grove,
No 14, Jalan Glenmarie (Persiaran Kerjaya),
Section U1, 40150 Shah Alam, Selangor, Malaysia.

COMPANY INFORMATION
Registered Company
The Thompson Paradigm Group Sdn Bhd
Name (Payee)
Company Address
(Line 1)

Suite B-11-5, Level 11, Tower B, Wisma Pantai, Plaza Pantai,

Company Address
(Line 2)

No. 5, Jalan 4/83A, Off Jalan Pantai Baru

Address (Postcode)

59200

Country of Supplier

MALAYSIA

Office Phone

+603 2282 8410

Office Fax

+603 2282 8434

Contact Name

Joey Wong / Keith

Thompson

Company Registration
No

912125-P

CONTACT INFORMATION
Pfizer requires generic email addresses wherever possible to avoid the specific e- mail addresses
being deactivated
Purchase Orders
registration@thethompsongp.com
Payment
Remittance

info@thethompsongp.com

Comments

info@thetompsongp.com

BANK DETAILS
Please provide bank details linked with the Registered Company Name.
Bank Name

RHB Bank Berhad

Bank Account Name (Payee)

The Thompson Paradigm Group Sdn Bhd

Bank Address

Damansara Jaya Branch, Selangor, Malaysia

Bank Account Number

212068-00086916

Pfizer remits in
MYR

Pls indicate if not in MYR

International Bank Account, please provide additional details below or provide intermediary
bank details if applicable:
SWIFT / BIC / IBAN
Bank Address
Intermediary bank details
Please tick the relevant box.
1 NGO N-HCP
Non-Govt Official Non-Healthcare Professional
2 NGO HCP
Non-Govt Official Healthcare Professional
3 GO HCP
Govt Official Healthcare Professional
4 GO N-HCP
Govt Official Non-Healthcare Professional
5 AGO
Associated with Govt Official
6 VIGO
Interacts with Govt Official
Print Name:
Keith Thompson

Signature:

Position:
Company Stamp:
CEO & Managing
Director
Please scan this form and email back to the requester

Date:
12/9/201
2

7 ANGO HCP
Professional

Associated with Non-Govt Official Healthcare

PAYMENT TERMS: Payment Terms are strictly 60 days (NET) from Invoice date

ACKNOWLEDGEMENT
I agree that the information provided above is true and correct at the time of signing this
request.