Account Application Form

Business Information

Full Trading Title (State if a Limited Company)*

Business Address (If a Limited Company give registered office address)

Type of Business

How long has the business been trading?

Company Registration Number

Main Phone Number

Area CodePhone Number

VAT Number

Invoice Address (If different from above)

Bank Details

Bank Name

Account Number

Bank Address

Accounts Contact

Accounts Contact Name

Email Address

Telephone

Fax Number

Principals & Partners

If not a limited company please give the names and addresses of the principals or partners.

Provide previous address if principals or partners have been resident less than 3 years.

Trade References

Trade Reference 1 (company name and address)

Contact Name

Credit Limit

Trade Reference 2 (company name and address)

Contact Name

Credit Limit

Aurthorisation

Amount of Credit Required?

Applicants Name

Our Payment Terms are thirty (30) days from the date of invoice.

I / we certify that the information supplied is correct and have read and accepted the attached trading ‘Terms and Conditions’ RHA & UKWA.

I / we have no objection to Dore to Door Specialist Handling Ltd taking the necessary steps to validate the information supplied.

By checking the box below you agree to our terms and condition.*

Applicants Signature (sign with your mouse)

Today's Date

Date