Form A. New Client Registration

User/Membership Registration

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Account Expiry Date

CLIENT INFORMATION

Type of Client(Required)

Applicant (Representative) Name(Required)

First Name Last Name

Occupation/Position(Required)

Phone/Telephone Number(s)(Required)

Email(Required)

Password(Required)

Create and confirm password for your account here

Enter Password Confirm Password

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ENTITY INFORMATION

Entity Location Category(Required)

Select the location category of your entity whether it is based locally (registered business, agents, clients and individuals in PNG) or overseas (entity based in other countries or has overseas address).

Purpose For Registration(Required)

For Homologation (Product certification) purposes in Papua New Guinea by Manufacturer Representatives and Agents.

For Commercial purposes (Local NICTA Licensed Dealers)

For Private and Non-commercial purposes (Non-licensed - local agent, business, agencies, individual, others)

Type of Entity(Required)

Registered Entity Name

Type of License

For NICTA existing Licensee, please select the type of your license from the drop down menu

License Number

Enter the license number

License Expiry Date

DD slash MM slash YYYY

IPA Certificate Number

Expiry Date

MM slash DD slash YYYY

IRC TIN

Expiry Date

MM slash DD slash YYYY

Website (optional)

Address

Building & Street Address Post Office Box Town / City State / Province / Region ZIP / Postal Code Country

ATTACHMENTS

Registration, Business Certificate, NID, Driver License, Passport, work ID, Cover Letter, Supporting Documents, etc.

Document Sharing by:

Please select the preferred method you wish to attach the files.

File Upload

External Link

Entity Documents

Registration, Business Certificate, etc.

Max. file size: 25 MB.

ID Documents

NID, Driver License, Passport, work ID, etc. (for verification purposes)

Max. file size: 25 MB.

Supporting Documents 1 (Optional)

e.g. Cover Letter

Max. file size: 25 MB.

Supporting Documents 2 (Optional)

Max. file size: 25 MB.

Links to Documents (Optional) e.g. Drobox, Google Drive, OneDrive, etc...

Entity Documents: Registration; Business Certificate; etc., ID Documents: NID; Driver License; Passport; work ID; etc., Cover Letter, etc.

INDENMITY STATEMENT

By submitting this request, you hereby acknowledge and agree that you are solely responsible for ensuring the accuracy, completeness, and truthfulness of all information provided. NICTA will not be held liable for any loss of business, financial implications, or other damages that may result from: (i) Errors, omissions, or inaccuracies in the information submitted. (ii) Failure to verify and properly check the details before submission. (iii) Delays or rejection of requests due to improper completion or false information. You further indemnify and hold harmless NICTA, its officers, employees, and agents from any claims, liabilities, or losses arising directly or indirectly from your submission of this form. It is your responsibility to thoroughly review all entries and ensure compliance with applicable requirements before submission. Thank you!

DECLARATION(Required)

By checking the box, you hereby declare that you have read and understood the Policy, Terms and Conditions such that all the information and particulars provided in this form and in the documents submitted are to the best of your knowledge true, correct and complete.
Any untrue, incorrect and/or incomplete information in this form and the documents submitted may lead to the declination of this request!

I agree to the Privacy Policy, Terms and Conditions and all the information submitted are true and correct!