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Credit Account Application
 
IMPORTANT NOTE: Orders will not be able to be invoiced to an open account until your application is approved. You may save an in-process order until your account has been approved, or pay with a credit card. Please allow up to 1 business day for your online account to reflect "Allow Terms" as a invoice option.

Please complete this application in full. If you have any questions, call 0800 66 33 55.
 
Credit Information
   
Credit Amount Requested
 
Business Information
   
Company Name
Trading Name .
Address
City
Postal Code
Country
Phone
Fax
Email
Company Reg No
   
How would you like invoices, statements and letters be sent? >
Email
Post
   
Has the firm or any of it's Principals ever been bankrupt?
Yes No
   
If yes, explain.
 
Ownership Information
   
Ownership
Sole Ownership Partnership
Linited Public Limited
   
Owner Name
Owner Title
Years In Business
PLC Company Director
Address
Telephone
Fax
 
Credit Terms Requested
   
Terms Length EOM 30 days
 
Trade References
 
Provide two suppliers of major products or services.
 
Reference 1
Company Name
Company Phone
Company Fax
 
Reference 2
Company Name
Company Phone
Company Fax
 
Bank References
   
Account No.
Bank Name
Bank Telephone Number
Bank Fax Number
 
Declaration
 

Applicant agrees to pay any collection and legal fees incurred to collect unpaid balance, including interest on the unpaid balance as per our terms and conditions. The undersigned as an inducement to grant credit warrants that the information submitted is true and correct. You are authorized to investigate the credit references listed above. In addition a credit eport will be obtained.

By clicking submit application you are aggreing to our terms and conditions.

   
Applicant's Name
   
Today's Date 17/04/2014
 
  
WEB SALE
 
 


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