Wholesale & Retail

Trade Account Application

Apply to become an approved retailer or wholesaler. Complete the form below — all applications are individually reviewed before activation.

Submission of this form does not automatically create a trade account. We may contact you for additional documents or clarification before approval.

Business Details

Business / Trading Name *

Registered Company Name (optional)

Business Type *

CIPC Registration Number (if applicable)

VAT Number (if registered)

Years in Business *

Website (optional)

Social Media Pages (optional)

Contact Person

Full Name *

Position / Title *

Email Address *

Mobile Number *

Telephone Number (optional)

Business Address

Physical Address *

Suburb / City *

Province *

Postal Code *

Delivery Address (leave blank if same as above)

Trade References

Please provide two suppliers or trade contacts who can confirm your business standing.

Reference 1 — Business Name

Reference 1 — Contact Person

Reference 1 — Phone / Email

Reference 2 — Business Name

Reference 2 — Contact Person

Reference 2 — Phone / Email

Supporting Documents

Please email the following documents

CIPC Registration Document
VAT Registration Certificate (if applicable)
ID of Owner / Director / Authorised Signatory
Proof of Business Address (not older than 3 months)
Bank Confirmation Letter / Proof of Bank Details
Reseller Certificate or Business Profile (if available)

Send documents to: wholesale@umlozi.com — please use your business name as the email subject.

Compliance & Declarations

I confirm that the information provided in this application is true, accurate and complete to the best of my knowledge. I confirm that I am applying as a retailer / wholesaler for resale purposes and not as an end consumer. I understand that approval of this application is at the sole discretion of the company and that submission does not guarantee account activation. I agree that pricing, supply, credit terms and trading conditions will only apply once my application has been approved in writing. I consent to the processing of my personal and business information for account verification, onboarding and trade communication purposes, in accordance with the Protection of Personal Information Act (POPIA) and applicable South African law.

Authorisation & Signature

Full Name of Signatory *

Date *

Electronic Signature — Type Your Full Name *

By typing your name you are signing this application electronically.

Your application will be reviewed within 3–5 business days.

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Estimated total

Trade Account Application

Business Details

Contact Person

Business Address

Business Profile

Trade References

Supporting Documents

Please email the following documents

Compliance & Declarations

Authorisation & Signature