Application Form for Cash Account

Application Form for Cash Account

Please fill out the following details to create your account. All fields marked with * are mandatory.
Name

First NameLast Name
Email Address **
example@example.com
Type of Account

PersonalBusiness
For Business please enter Company Name
if Applicable
Phone Number **

Area CodePhone Number
Address with EIRCODE **

Street Address

Street Address Line 2
CityState / ProvinceEirCode
Additional notes or requests:
Please enter any additional information including secondary contacts or accounts. Please include email and phone number

We send reminder lists to all contacts on Thursdays of every week.
Proof of Address Part 1. Photographic ID

Valid Passport, Driving Licence. Not a selfie. You can also upload proof of address here. Please see notes below for requirements. If you can not upload for any reason please bring the original with you when collecting.
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Proof of Address Part 2. Proof of Address

If you have uploaded a valid dirving license please upload 1 Proof of address with cosrresponding details. With all other photo ID that does not include addreesses Please upload 2 proof of address. These include Utility Bills, TV or Phone Bills, Credit Card Statement, Bank Statement Headers, Insurance Certs, Revenue Letters. If you can not upload for any reason please bring the original with you when collecting.
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I or We accept and agree to comply with A-Z Hire Ltd T&C available at https://www.azhire.ie/terms-conditions . I or We confirm that all the information provided is true and complete. I or We give my OR our concent to a credit search being made on me or as owner(s) or Partner(s) OR Director(s) of the business both now and at a future date. I or We understand this search may be recorded and may be disclosed to subsequent enquiries. In the case of a Company I the above named applicant have authority to sign on its behalf.*

I / WE Agree to these terms
Authorised Signature **

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