Trading Account Application

Trading Account Application

Coolicon Lighting Ltd
Please complete this form before placing your first order with us.

In order to complete this form, you will need the following information handy:
- Company contact details
- Company address
- Delivery address (if applicable)
- VAT / TAX number (if applicable)
- EORI number (if applicable)
Company and Contact Information
Company Name*
Registered Company Number*
Contact Name*

First NameLast Name
Contact Phone Number*

Country CodePhone Number
Contact Email*
example@example.com
Shipping
Invoicing Address*

Street Address (Line 1)

Street Address (Line 2)

Town / CityState / Province

Post / Zip CodeCountry
Delivery Address is different from Invoicing Address
Delivery Address

Street Address (Line 1)

Street Address (Line 2)

Town / CityState / Province

Post / Zip CodeCountry
Delivery Contact Name (if applicable)

First NameLast Name
Delivery Contact Phone Number

Country CodePhone Number
Delivery Preferences (if applicable)

Import / Export Information
VAT / TAX Number (if known)
EORI Number (EU Customer Requirement)
Working with an Import Agent
Import Company Name
Agent Name

First NameLast Name
Agent Phone Number

Country CodePhone Number
Agent Email
example@example.com

Additional Comments
Relevant information will be treated as confidential and will be handled in accordance with current EU GDPR and UK GDPR legislation where applicable.

The following territories will have accounts processed in EURO; Austria, Belgium, Croatia, Cyprus, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Portugal, Slovakia, Slovenia and Spain.
All other territories will have accounts processed in GBP.
Should be Empty: