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DISTRIBUTOR QUESTIONNAIRE (Please note: replies without financial statements will not be considered)

User info
Date:	07.09.2010.
Company name:
Address:
Phone:
FAX:
Completed by:

1) Are you:
Manufacturer
Wholesaler
Importer
Distributor
Retailer

2) What year was your company established?
Kalendar

3) What country (or countries) do you service?


4) What type(s) of products do you currently sell/manufacture?
Prescription Pharmaceuticals
Non Prescription, over-the-counter (OTC) Pharmaceuticals
Cosmetics
Other (please specify)

5) List the companies you currently represent (in case you do), what city they are based in, and the type of product(s) and brand names they supply you with. (If you have too many to list here, list the ones most closely related to our industry or attach separate sheet).
Company Name
City, Country
Brand Name/Product Function

6) What was your company's sales volume in Euro for the last 5 years?
last 5 years last year

7) How many sales representatives do you have?
Employees
How many will handle JGL lines?
How many customers are visited regularly?
How often?
Commission Reps

8) Will you employ a full time marketing manager for the JGL lines?
Yes No

9) Channels of distribution:
Direct sell
Drug Stores
Supermarkets
Wholesalers
Dept. Stores
Beauty Salons
Beauty Supplies
Variety Stores
Other

10) Specify Tariff rate / Import Duties. Specify International sales tax on VAT tax rate.


11) How do you support your product lines in general?
Advertising
Consumer magazine
Newspaper
Trade Magazine
Professional Magazines (Doctors and/or Dentists)
Local Radio
TV
Promotional Activity
In store events
Special pricing
Direct Mailers
Sample support
Detailing of Doctors, Dentists
Other

12) Is local language product labeling required in your markets(s)?
Yes No

13) Name and Address of your bank:
Name:
Address:
Account:

14) Give three credit references, including complete names, addresses and phone numbers:
Contact Name:
Company Name:
Address:
Phone Number:

Contact Name:
Company Name:
Address:
Phone Number:

Contact Name:
Company Name:
Address:
Phone Number:

15) List names and titles of your principal executives:
Managing Director/General Manager/President
Vice President/Manager - Marketing
Vice President/Manager - Sales

16) Normal trade selling terms and conditions to your customers:


17) Please attach latest annual report or audited financial statement.