New Trade Account Application

New Trade Account Application

Please complete all questions within this application form to ensure your account is processed as quickly and efficiently as possible. Please ensure that you have read and understood our terms and conditions of sale.
Applicant Details
Name*
Premises Name in Full*
Legal Status of Business*
Address of Premises (Delivery Address)*

State / Province
Is the Registered Name and Address the Same as Above?*
Registered Name and Address

State / Province
Contact Phone Number*
Email Address*
Has the owner or partner been involved in a failed company that left unpaid creditors?*
Please provide details below
Identification*

Upload photo of drivers license or passport
Cancelof
Company Number
VAT Registration Number
Date Trading Started*

DayMonthYear

Signature
Please sign in the box below to confirm the above details are correct. It is the applicant's responsibility to update Cellar Drinks Company Ltd with any change of circumstances.

By signing this form you are requesting to open a trade account with Cellar Drinks Company Ltd pending acceptance of your application.
Please sign in the box below*

Clear
Full Name*
Position*
Date*

DayMonthYear
Should be Empty:

Applicant Details