EmailMeForm
EIRS Card Dealer Registration
Dear Sir,
I/We are applying to register with the EIRS as a card dealer or sub-dealer.
My/Our detailed Information are given below ( Please use CAPITAL letters)
Business TIN
Select the dealer type you wish to apply for
*
Dealer
Sub Dealer
CAC Registration Number
*
Business Name
*
Address of Business (must be located in Edo State)
*
Business Branches (if any) (must be located in Edo State)
*
Local Government Area
*
Contact Person
*
Contact Person TIN
*
Role of Contact Person
*
Managing Director
Executive Director
Business Owner
Manager
Others Specify
Email Address of Contact Person
*
Confirm Email Address
Mobile Number of Contact Person
*
CAC certificate of Incorporation
*
pdf, jpg or png
VAT Certificate
pdf, jpg or png
Upload Tax Clearance Certificates obtained from EIRS over the last 3 years
*
pdf, jpg or png
