Account Application Form

Account Application Form
Company Type:
Full Trading Name
Invoice/Trading Address

Street Address

Street Address Line 2

CityCounty

Postal Code
Proprietor/Partner's Details (Names & Addresses):
Company Telephone Number:
Company Registration Number:
Company Web Address:
Purchasing Contact Name:
Purchasing Contact Email:
Purchasing Contact Mobile Number:
Do you have a standard purchase order number format?
Purchase order number format:
How did you first hear about MIDFIX?
Are you associated with any other company who already holds a trading account with MIDFIX?
Associated company details:
Name of the person responsible for paying the account:
Email address of the person responsible for paying the account:
Email address for invoices and statements:
Credit limit required (£)
Our standard terms of settlement are 30 days nett from end of month of invoice. Is this something you can accommodate?
If 'NO' please state the alternative terms agreed:
Please note our preferred method of payment is BACS. Our bank details are contained on the attached link.

BANK DETAILS

When making payments please quote your account number and email remittances to
salesledger@midfix.co.uk
Additional Information to support your application:
THIS DECLARATION MUST ONLY BE SIGNED BY A DIRECTOR, PARTNER, PROPRIETOR OR LEGALLY AUTHORISED OFFICER
I, being a duly authorised officer of this business, have read and understood your Terms & Conditions (as detailed on the link below) and I agree that business will be conducted on these terms which take precedence over our own Terms & Conditions.

I agree that payment of all accounts will be received by you (our supplier) within your stated terms, which are 30 days nett from end of month of invoice (unless otherwise agreed).

Title to the goods we purchase shall not pass to us until payment is received and cleared to you (our supplier).

I appreciate that adherence to this obligation is the essence of the contract between us.
TERMS & CONDITIONS
Please note that to determine your credit worthiness we use credit reference agencies and/or other third parties. However, we may occasionally need to refer to you for additional information such as trade references or management accounts to support your application. We may also disclose information about the conduct of your account to these credit reference agencies and/or other third parties.
Signed
Applicant Full Name
In what capacity
Should be Empty:

Account Application Form

THIS DECLARATION MUST ONLY BE SIGNED BY A DIRECTOR, PARTNER, PROPRIETOR OR LEGALLY AUTHORISED OFFICER