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Account
Account Form
"
*
" indicates required fields
Business / Trading Name
*
Business Type
*
PLC
LTD
Partnership
Sole Trader
Details of People Authorised to Place Orders
People Authorised to Place Orders
First Name
Last Name
Position
Add
Remove
Email
*
Business Phone Number
*
Business Address
*
Street Address
City
County
Postcode
Are any of the Directors, Owners or Partners in this business an un-discharged bankrupt?
*
Yes
No
Have any of the directors, owners or partners held any other credit accounts with us?
*
Yes
No
Sole Traders / Partnerships Information
Proprietor / Partner Name
First
Last
Address
*
Street Address
City
County
Postcode
Proprietor / Partner Name (optional)
First
Last
Address
Street Address
City
County
Postcode
Date of Birth (optional)
DD slash MM slash YYYY
Name of People Authorised To Make Payment & Co Bank Details
Name
*
First
Last
Direct Tel No
*
Email
*
Bank Name
*
Branch Name
Sort Code
*
Account Number
*
Trade References
Name
Address
Current Credit Limit
Add
Remove
In processing your application for credit facilities we make enquiries of credit reference agencies and other third parties who may record those enquiries. We may also disclose information about the conduct of your account to credit reference agencies and other third parties. The information obtained from or provided to credit reference agencies or other third parties may be used when assessing further applications for credit terms, for debt collection, for tracing and for fraud prevention. I, the undersigned hereby confirm that if credit facilities are approved the account will be paid as per your normal monthly terms.
I confirm I am a Director, Partner or Proprietor of the business.
I confirm I am a Director, Partner or Proprietor of the business.
Date
*
DD slash MM slash YYYY
Signature
*
I have read and agree to the Terms and Conditions and Privacy Policy
I have read and agree to the Terms and Conditions and Privacy Policy