Name
*
First Name
Last Name
Email
*
example@example.com
Telephone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
Company Name
*
Trading Style
*
Please Select
Sole Trader
Partnership
Limited Company
Other
Year Business Started
*
Number of Employees
*
Amount of Credit Required Per Month
*
Company Registration Number
*
More Information
Partner 1
If applicable
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Partner 2
If applicable
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Partner 3
If applicable
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name and address of registered office (if different from address added previously)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Registered Number
Year of incorporation
Issued Capital
Nature of Business
*
National House Builder
Regional House Builder
Timber Frame
Merchant
Local Builder / Contractor
Cash Sale / Self Build
Other
If you are a branch or subsidiary of a larger group, please list the name and address of the registered office
Name of group business
Address of group business
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Next
Accounts Contact
Name
*
First Name
Last Name
Email
*
example@example.com
Telephone
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
This contact information is the same for:
Invoicing
Statements
Purchasing Contact
Name
*
First Name
Last Name
Email
*
example@example.com
Telephone
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Where should invoices be sent?
Name
*
First Name
Last Name
Email
*
example@example.com
Telephone
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Where should statements be sent?
Complete if different from above
Name
*
First Name
Last Name
Email
*
example@example.com
Telephone
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
Signature
This section must be the signature of a Director of the business as listed on Companies House
*
First Name
Last Name
Signature
*
Date
*
-
Month
-
Day
Year
Date
Position in Company
*
Please provide any additional information that may be useful for your application.
Complete
Complete
Should be Empty: