Application for Credit Account

APPLICATION FOR CREDIT ACCOUNT

Sales Reps Name:

Company Name:

Trading Name (if different):

VAT Number:

How long has business been established:

Are the business premises: Freehold/Leasehold/Rented

Are You a Limited Company: YES/NO

If Yes Please enter:

Registered Office:

Registered Number:

Date of incorporation:

If No Please enter:

Name and Address of Owners/Partners:

Are you a part of a Group/Subsidiary or own any other companies: Yes/No

If Yes please specify other connected companies:

(Restaurants/Bars/Pubs etc.)

Do you wish them to trade with us: Yes/No

If Yes Please specify

Contact Name:

Telephone Number:

Delivery Address: Invoice Address:

Contact: Contact:

Telephone: Telephone:

Fax: Fax:

Finance Office/Statement Address:

Contact: Position:

Telephone: Fax: P.T.O

Bank Name: Address:

Sort Code: Account Number:

I authorise the above named company to be provided with a bank reference on request

Signature: Date:

Name (Please Print): Position:

Credit Limit Applied for:

Trade References (of at least 6 months standing)

1. Name: 2. Name:

Address: Address:

Telephone: Telephone:

Fax: Fax:

Directors/Partners Declaration:

I hereby declare that the information given by me is truthful and I understand that it is my responsibility to inform Jacksons (Clear Glass) Ltd of any change to the said details (e.g. trading titles or legal entity). I/We agree to be responsible for payment of accounts and to comply with Jacksons (Clear Glass) Ltd trading terms.

(Terms are strictly 30 days from date of invoice)

Signature: Date:

Name (Please Print): Position:

NB – No orders may be processed until this form is completed in full and returned to Jacksons (Clear Glass) Ltd Accounts Department along with a sample letterhead or other suitable identification of the applicant business. Please note although your application will receive our immediate attention, there may be some delay before your account is opened due to circumstances beyond our control. If goods are required before the account is opened they will have to be supplied, cash on delivery basis. We would also like to inform customers, it is company policy for all credit accounts to be considered they should have minimum of six months trading and should be able to provide references to this effect. If you are new company with no trading history your account will be opened on cash on delivery. Once you have traded with us for six months your account for credit terms can be reviewed on request.