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Credit account application form

COMPANY DETAILS

Business/Trading Name *
Business Type (i.e. Limited Company, Sole Trader) *
Other (please state):
Invoice/Correspondence Address *
Town/City *
Postcode *
Main Telephone No. *
Email Address *
Company Registration No. *
Date of Incorporation *

DIRECTORS/PARTNERS/TRADERS DETAILS

Name *
Home Address *
Postcode *
Name
Home Address
Postcode
Name
Home Address
Postcode
Do any of the Directors, Partners or Traders have any un-discharged bankruptcies and/or CCJ's against them? *
Have any of Directors, Partners or Traders held any other credit accounts with us? *
If yes, please provide the name of the account was/is in:
Requested credit limit
Is a purchase order required? *
Please provide an email address and contact number for invoices, statements and necessary accounting and purchase ledger correspondence.
Email: *
Phone: *

REFERENCES

Please supply the names and contact details for two trade references. Please note you need to hold credit accounts with these companies, to be valid referees. Most large builder’s merchants do not supply references.

Name *
Address *
Relevant Email *
Tel Number *
Name
Address
Relevant Email
Tel Number

YOUR BUSINESS

To help us categorise your business correctly on our system and provide you with accurate and relevant pricing we also need the following details:

Business descriptor: *
Other (please state): *
Area of business you trade with: *
Which site do you visit most: *
We may from time to time send you email communications regarding business updates, promotions or pricing information relating to our products and services. Please tick the box if you are happy to receive this information.

In accordance with with our environmental commitments, all correspondence in terms of account information, invoicing, statements or business specific updates will be communicated to you via email.

CREDIT TERMS

In processing your application for credit facilities, we make enquiries with credit reference agencies and other third parties who may record those enquiries. We may also disclose information about the conduct of your account to credit reference agencies and other third parties. The information obtained or provided may be used when assessing further applications for credit terms, for debt collection, for tracing and for fraud prevention.

This application and any credit facility approved is subject to our Conditions of Sale. (Available on request). New Milton Sand and Ballast Limited and their incorporated companies reserve the right to withdraw credit facilities upon breach of contract by the customer or any condition with all amounts then outstanding due to forthwith. Any credit facility approved will be subject to a credit limit. Should this limit be exceeded then an interim payment will be required before trade can continue.

DECLARATION

To be signed by a Director, Partner, Owner of the business, or authorised person only.

I agree and understand that by typing my name in the box below, that this electronic signatures is the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.
Name: *
Position: *
Date: *