Account Application Form

Company Name

Type of Business

VAT Registered

VAT Number

Company Registration Number

Address

Street Address

Street Address Line 2

TownCounty

Postcode

Contact Name

Telephone Number (Work)

Area CodePhone Number

Email

example@example.com

Authorised Callers:

Optional

Date

DayMonthYear

Our sales accounts are factored by Basildon Taxis Ltd.

BACs payments to:

Sort Code 30-15-99

Account No 14171760

Please remember to quote the invoice number on all payments. Remittance advice should be sent to accounts@abtaxis.co.uk.

For any account queries, please call 01268 555555

Authorised signatory only to complete this section.

I/We hereby request to open a credit account. I/We agree by your credit terms which require payment within thirty days of invoice date and agree to a 5% admin charge on all invoices.

Signature

Print Name:

Position: