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Applicant Details
Full Name Of Person Authorising    Position:
Trading Name
VAT No. (If registered)
Address
City/County/State
Country
Postal/Zip Code
Email Address @
Telephone No.
Fax Number
If the Registered Company Address is different from above please fill in details below
Registered Name
Registered Address
City/County
Postal Code
Account Department for Invoices and Statments (If different from Applicant Details)
Invoice Address
City/County
Postal/Zip Code
Contact Name
Job Title
Telephone Number (inc. area code)
Fax Number (inc. area code)
Please tell us about your business
Main Area Of business
Company Type (e.g. Plc, Ltd)
Premises Type (e.g. shop, office)
No. Of Employees

Name of Executives

   Position:
   Position:
   Position:
   Position:
   Position:

Business incorporated under Companies Act 1948
Share capital-authorised (£)
Share capital-Issued (£)
Date of formation / / (dd/mm/yyyy)
Date of financial year-end / / (dd/mm/yyyy)
Company Reg. Number
If applicable, please fill in the details of the ultimate holding company
Holding Company Name
Address
City/County
Postal Code
No. of employees in Group
No. of locations
Bank References
Bank holding main account
Bank Name
Bank Address
City/County
Postal Code
How long A/C open?
Account Number
Sort Code
Secondary Bankers (If applicable)
Bank Name
Bank Address
City/County
Postal Code
When was A/C opened? / / (dd/mm/yyyy)
Account Number
Sort Code
Trade References
Supplier 1
Suppliers Name
Address
City/County
Postal Code
Main trading activity
Period of trading with supplier Month(s)   Year(s)
Contact Name    Position:
Telephone Number (inc. area code)
Supplier 2
Suppliers Name
Address
City/County
Postal Code
Main trading activity
Period of trading with supplier Month(s)   Year(s)
Contact Name    Position:
Telephone No. (inc. area code)
Extent Of Credit Required
Normal payment period from receipt of invoice 28 Days from date Month - STRICTLY!
Amount of credit required (£)
Estimated annual purchases (£)
Payment Method (e.g. cheque)
Purchase Procedures
Please Give details on Person(s) authorised to place orders on your behalf
Authorised Purchaser    Position:
   Position:
   Position:
   Position:
   Position:
   Position:
Please state any special purchase conditions or procedures