Credit Application Form


Full Trading Name .................................................................................................................................................................
Limited/Partnership/Sole Trader (please circle one) Company Registration No. ..................................................
Full Address ........................................................................ Managing Director's Name ...................................................
............................................................................................ Reg. Office ..........................................................................
........................................... Post Code ............................... ......................................... Post Code ..................................
Telephone No. .................................................................... Fax .....................................................................................
Sole Trader or Partnership please complete the following: If a limited company, please supply a Director's name
Sole Trader/Partner No.1/Director Partner No.2
Full Name .......................................................................... Full Name ..........................................................................
Home Address .................................................................... Home Address ....................................................................
.............................................. Post Code ............................ .............................................. Post Code ...........................
Telephone No. .................................................................... Telephone No. ....................................................................
Date Business Established ................................................... Bank Reference ....................................................Bank/BS
Type of Business .................................................................. Address .............................................................................
Payments Contact ................................................................. ...........................................................................................
Department............................................................................. .............................................. Post Code ............................
Tel. No. (if different) ............................................................... A/c ......................................... Sort Code .........-.........-........
2nd Contact Name ................................................................. Name of Account .................................................................
Trade Ref No. 1 Trade Ref No. 2
Name .................................................................................... Name ....................................................................................
Address .................................................................................. Address ..................................................................................
............................................................................................... ...............................................................................................
.............................................. Post Code ................................ .............................................. Post Code ...............................
Tel No .................................................................................... Tel No ...................................................................................
Contact ................................................................................... Contact ..................................................................................
Accountants Details: Name ...................................................................................... Tel No ........................................................
Contact ....................................................................................... Date of Year End ...............................................................
Please accept this form as my/our application for a credit account. Estimated monthly sales of £: ................................

Signed .............................................................................................................................................. Director/Partner/Owner

I/we give my/our consent to a credit search being made on me/us as owner/partner or director of this organization both now & at any

future date. I/we understand this search will be recorded by the agency & may be disclosed to subsequent enquirers.