Full Trading Name:
If Limited Company or Public Limited Company:
Registered Office Address 1:
VAT Registration No.
Year of Incorporation:
Company Registration No.
If Sole Trader or Partnership give full names and private addresses of all partners:
Sole Trader/Partnership 1
Sole Trader/Partnership 2
Sole Trader/Partnership 3
Sole Trader/Partnership 4
Name and Address of 2 Trade References:
Trade References 1
Trade References 2
Please state credit limit required:
Name of your Managing Director or Senior Partner:
Name of person responsible for paying account on time:
Declaration by Credit Applicant:
I have read the terms and conditions of sale.
I, being an authorised Officer of this business, do agree to adhere to those terms and conditions and that payments of all accounts will be received by you (our Supplier) within your stated credit terms. (30 days from the end of month of invoice)
I agree with the storage and handling of my data by this website and agree for contact to be made with me if required.