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Company Details

Company Type

If other, please specify

Company Name

Registered office address

City

Postcode

Years Established

Company Reg. No.

VAT Reg. No.

Personal Details

Name

Email Address

Telephone

Address

City

Postcode

Sales Contact

Only complete this section if different from main contact

Name

Email Address

Telephone

Address

City

Postcode

Accounts Contact

Only complete this section if different from the main contact

Name

Email Address

Telephone

Address

City

Postcode

Technical Contact

Only complete this section if different from the main contact

Name

Email Address

Telephone

Address

City

Postcode

Bank Details

Bank/Building Society Name

Bank Account Name

Bank Address

Postcode

Bank Sortcode

Bank Account Number

Delivery Details

Delivery Address

City

Postcode

Trade Details

Trade Reference 1

Trade Reference 2

I/We authorise you to take up references at any time from the under mentioned bank and trade sources (we will make searches with a credit reference agency, which will keep a record of those searches and will share that information with other businesses. We may also make enquiries about the principal directors with a credit reference agency.)

Please upload any 2 of the following:

Company Registration Certificate
VAT Certificate
Business bank statement (dated within the last 3 months)
Business utility bill (dated within the last 3 months)

Proof of Trade

Method of Payment

Cash Account (BACS)

Credit/Debit Card

Credit Account

Credit Limit Requested

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