Eco-Pan Account Application Form
Please complete the form below to apply for a New Account.
Name of Company or Individual
*
Trading Name (if different)
Type of Business (please tick box)
*
Limited Company
Partnership
Individual
What region will your work be undertaken?
Please Select
London and The South East Only.
Who is your area contact?
*
Please Select
Chris Barret - chris.barrett@camfaud.co.uk
David Mann - david.mann@camfaud.co.uk
Mark Watts - mark.watts@camfaud.co.uk
James George - james.george@camfaud.co.uk
Company Registration No.
*
Numbers only without spaces or letters
Are You VAT Registered?
*
Yes
No
VAT Registration No. (please enter N/A if not applicable)
*
This is 9 digits long and no spaces or letters
Are You CIS Registered?
*
Yes
No
Unique Taxpayer Reference (UTR)
*
This is 10 digits long and no spaces
End User Status
*
Never an end user
End user (please provide site address below)
Site Address
Street Address
Street Address Line 2
City
County
Post Code
Full Registered Address
*
Street Address
Street Address Line 2
City
County
Post Code
Main Telephone No.
*
Main Office Email
*
example@example.com
Main Office Mobile No.
*
Credit Limit Requested
*
Bank Details
*
Street Address
Street Address Line 2
City
County
Post Code
Bank Account No.
*
Bank Sort Code
*
Full Accounts Address (if different from above)
Street Address
Street Address Line 2
City
County
Post Code
Name of Accounts Contact
*
Main Accounts Telephone No.
*
Main Accounts Email Address
*
example@example.com
Statement Email Address
*
example@example.com
Invoice Email for e-invoicing via Tradex
*
example@example.com
Please verify that you are human
*
SEND
Should be Empty: