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Trade Accounts

 Credit Account Application Form

To apply for a 30 day credit account with us please complete and submit the form below. PLEASE NOTE: YOU MUST AGREE TO OUR 30 DAY (FROM DATE OF INVOICE) PAYMENT TERMS TO SUBMIT YOUR APPLICATION.

 

 

Customer Information

Company Name

Address 1

Address 2

Town / City

County / State

Post / Zip Code

Country

Telephone Number

Fax Number

Nature of Business

Company Registration Number

Contacts

Director / Owner

Telephone Number

Accounts Contact

Telephone Number

Finance Director

Telephone Number

Purchasing

Telephone Number

First Reference

Reference Company Name

Contact Name

Address 1

Address 2

Town / City

County / State

Post / Zip Code

Country

Telephone Number

Fax Number

Second Reference

Reference Company Name

Contact Name

Address 1

Address 2

Town / City

County / State

Post / Zip Code

Country

Telephone Number

Fax Number

E-mail Addresses

For Order Acknowledgements

For Invoices

For Statements

Other

Credit Limit Requested

Your Name

Your Telephone Number

Your Position

Your E-mail Address