Credit Application for Business Account Form

Business and Credit Info
Accounts Payable Contact*

First NameLast Name
Accounts Payable Phone*

Area CodePhone Number
Accounts E-mail*

Confirmation Email
Requested Credit Limit*
Trading Address*

Street Address

Street Address Line 2

Town/CityCounty

PostcodeCountry
Bank Name*
Bank Address*

Street Address

Street Address Line 2

Town/CityCounty

PostcodeCountry
Company Letterhead

Browse Files
Please upload your current company letterhead Cancelof

Business References

If you are not a Limited Company please provide two Trade References
Reference (1): Company Name
Address

Street Address

Street Address Line 2

Town/CityCounty

PostcodeCountry
Phone Number (1)

Area CodePhone Number
E-mail of Contact (1)
Type of Account with this company (1)
Credit Limit Given (1)
Reference (2): Company Name
Address (2)

Street Address

Street Address Line 2

Town/CityCounty

PostcodeCountry
Phone Number (2)

Area CodePhone Number
Type of Account with this company (2)
Credit Limit Given (2)

Servicing your Account

Please answer a few questions so we can provide you with the best service possible.
Email
example@example.com
Contact for Order Enquiries

NamePhone Number
Contact for Order Enquiries Email
example@example.com
Contact for Account Enquiries

NamePhone Number
Contact for Account Enquiries Email
example@example.com
Do you use Order Numbers*

YesNoOther
Email address for invoice/Credit Notes to be sent
example@example.com
Email address for Statements (If different from above)
example@example.com
Agreement

(By checking these boxes you are agreeing to our terms - should you have any questions please contact us)
Agreement and Terms*

All invoices are to be paid 30 days following the month in which you've been invoiced. Late payments: Interest may be charged at 8% above Bank of England Base Rate, plus reasonable recovery costs, under the Late Payment of Commercial Debts (Interest) Act 1998. Full terms and conditions can be found on our website www.buildingplastics.co.uk/terms
Agreement and Terms*

By submitting this credit application, you authorize us to make inquires into the banking and business references that you provided.
Enter the word as it's shown*
Signature

Powered by Jotform SignClear
Name

First NameLast Name
Should be Empty:

Business and Credit Info