application for credit account

company information

 
1 Trading Title / Name: 
2 Head Office Address:
3 Trading Address (if different to above):
4 Telephone Number:
5 Fax Number: 
6 E-mail: 
7 Internet: 
8 Number of Years Trading :
9 VAT Number:
10 Legal Structure: Incorporated Company (answer question 11)
Sole Trader (answer question 12)
Partnership (answer question 13)
Other
11 If Incorporated Company:
Registered Office Address:
Registration Number:
Date of Incorporation (dd/mm/yy)
 Now skip to question 14
12 If Sole Trader:
full name:
private address:
Telephone Number:
How many years at this address:  
Now skip to question 14
13 If Partnership:
Please enter full name, address, telephone number and number of years at that address for each partner:  
Now skip to question 14
14 Account Payments
Name of Person Responsible:
Title:
Telephone Number:
Ext:
Fax:
15 Bankers
Name:
Address:
Telephone Number:
Date Account Opened:
Account Number:
Sort Code:
Credit Required £
Name of Managing Director:
Name of Financial Director:
Name of Company Secretary:
20 Trade Reference 1:
Company:
Address:
Contact:
Telephone Number:
Date Account Opened:
Annual Value of Credit:
Trade Reference 2:
Company:
Address:
Contact:
Telephone Number:
Date Account Opened:
Annual Value of Credit:

The above statement has been carefully read by the undersigned and is to the best of my/our knowledge, in all respects complete and accurate. In addition I/We have also read and accepted agreement of the Eltime terms and conditions of sale.

Name
Title
Date