Application for the Registration as a Registered Supplier

This form may take you 5 minutes to complete.
You will need the following information to complete the form:

Business particulars

The application for the registration as a registered supplier must be accompanied by the following documents:

Completed application form below
Original and photocopy of the applicant’s NRIC

The application must be made in person at NEA’s Customer Service Centre located at:

2nd Storey
Environment Building
40 Scotts Road
Singapore 228231
Tel: 1800 2255 632

Operating hours:
Mon – Fri 8.30am – 5.30pm
Sat 8.30am – 1.00pm

Instructions on completing the form:

a) Complete all fields, then click ‘Preview’.
b) In the ‘Preview’ page, verify information provided. To make changes, click ‘Modify’. Otherwise, click ‘Print’ to confirm.Note: Please select A4 size paper before printing.
c) Sign and stamp the printout.

I. Applicant's Details
1.	Company Name (as registered with the Accounting and Corporate Regulatory Authority)	*:
2.	Address	*:
3.	Postal code	*:
4.	Business Registration No.	*:
5.	Date of Registration (e.g 02-JAN-2007)	*:

II. Contact Information
6.	Name	*:
7.	Designation	*:
8.	Tel	*:
9.	Fax	*:
10.	Email	*:

III. Registered By
11.	Name (as in NRIC)	*:
12.	Designation	*:
13.	Company Name	*:
14.	Tel	*:
15.	Fax	*:
16.	Email	*:

IV. Declaration

We hereby apply to the National Environment Agency for registration as a registered supplier pursuant to Section 40D of the Environmental Protection and Management Act 2007.

We have read and understood the information issued by the National Environment Agency in relation to the application for registration as a registered supplier and certify that we have given all the necessary documents and information in support of our application. Furthermore, all statements and documents furnished in this application are true to the best of our knowledge and belief. In the event that any statements or declarations made by us are false or in any material aspect misleading, we are aware that we shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $2,000 or to imprisonment for a term not exceeding 3 months or to both.

We are also aware that if the required documents and/or information are insufficient, our application may be delayed or rejected. In the event that our application is rejected for any reason whatsoever, we are further aware that all payments made to NEA, if any, are strictly non-refundable and NEA will not be held liable for any expenses incurred for the application.

Should our application be approved by NEA, we understand that the registration as a registered supplier will only come into effect from 1 January 2008 onwards.

* denotes compulsory fields