Credit Account Application
Curveball Solutions
To complete this form, you will need the following information to proceed. Please check you have all items on the check list as this form is unable to save progress.
Legal Status of Company & Registration Number
V.A.T. Number (if applicable)
Accounts Details
Trade References
Banking Details
Monthly Credit Requirement
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Business Details Applying for Credit
Company Name:
*
Legal status of your business
*
Please Select
Limited (Ltd)
Limited Liability Company (LLC)
Sole Proprietor
Public Limited Company (PLC)
Charity
Trading name if different from above
Company Registration Number
Numeric value only
V.A.T. Number
Numeric value only
Date commenced trading
/
Day
/
Month
Year
Date
Number of employees
Company turnover
Purchase Order required
Please Select
Yes
No
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Business Address
Where services will be consumed from or install at
Address
*
Phone Number
*
Please enter a valid phone number.
Email
example@example.com
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Accounts
Finance Department Contact
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Is the Accounts address the same as previously entered
*
Yes
No
Address
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Trade References
The following companies with whom we are currently dealing with may be approached for trade references
Reference 1
Business / Supplier name
Referee name
*
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Reference 2
Business / Supplier name
Name
*
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Reference 3
Business / Supplier name
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
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Bank Details
Bank Name
*
Account Number
*
Sort Code
Our preferred payment method is via Direct Debit
*
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( X )
Direct Debit Setup
Initial setup of payments for services provided by Curveball Solutions
£
1.00
for each
month
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Credit Requirement
We wish to apply for credit facilities and agree to abide by your credit terms. We are fully aware of your conditions of trading and agree to abide by same. Failure to comply with these terms will result in immediate removal of credit facilities.
Monthly Credit Requirement
*
Amount in GBP
Signed for and on behalf of:
*
Please Select
Director
Company Secretary
Partner
Sole Proprietor
Signature
Signature Name
First Name
Last Name
Name of Company / Partnership
Date
-
Day
-
Month
Year
Date
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