/ Fax: 012 – 547 2260
Admin: 082 444 6125
E-mail:
Reg No: 2000/028095/23
Vat No: 4330247422 / P O Box 80056
Doornpoort
Pretoria, 0017
Cell: 083 454 3967
071 682 9136 / Towing & Recovery Services
Rotating Crane Facilities
Accident,
Breakdown &
Mud Recoveries

AANSOEK OM KREDIET / REKENING

CREDIT / ACCOUNT APPLICATION

Voltooi asb onderstaande vorm en faks terug na: 012 547 2260 of email na:

Please complete relevant document and fax to: 012 547 2260 or email to:

Naam van Besigheid:
Name of Business/Company:
Bk/CC / Pty Reg. Nr.:
Direkteur /Director:
Bestuurder / Manager:
Direkteur / Manager kontak no:
Director / Manager contact nr.:
Kontak persoon wat betalings hanteer:
Contact person who handle account payments:
Rekeninge Kontak persoon telefoon no:
Accounts Contact person telephone nr.:
Rekeninge epos adres:
Accounts email adress:
* VAT NO:
Posadres / Postal Adress:
Straat Adres / Street Adress:
Besigheids kontak besonderhede / Business contact details:
Telefoon no / Telephone nr.:
Faks no / Fax nr.:
Sel no / Cell nr.:
* epos addres/ email adress:
Rekening kliënte se betalings moet geskied op die 15de of die 30ste maandeliks.
Account customer payments must be made monthly on the 15th of the 30th.
Merk asb u betalingskeuses / Please tick your payment methods:
15de maandeliks: 15th monthly / 30ste maandeliks
30th monthly
Elektroniese oorbetaling
Electronic payment / Tjek betaling
Cheque payment

Skakel asb vir André Botha 083 454 3967 of Annelie Botha 082 444 6125 in verband met enige navrae. Dankie.

Please contact André Botha 083 454 3967 or Annelie Botha 082 444 6125 in case of any queries.

Thank You.

Thank you for your business