New Account Form

New Account Form

All information will be treated as strictly confidential.
Account & Business Details
Account Opened By*
Sole OwnerLimited CoPlcOther
Company Name*
Trading Name
Company Registration Number
VAT Number
Contact & Address Details
Telephone Number*
Please enter a valid UK phone number.Format: 0000 000 0000.
E-mail Address*
*By providing your email address you agree to receive e-mails from United Eyecare Ltd, including promotional offers. Your information will not be shared with any 3rd parties.
Delivery Address*

Address Line 1

Address Line 2
Town / CityCountyPostcode
Business Background / Ownership
Date Business Commenced

MonthDayYear
Date
Full Name of Owner 1
Full Name of Owner 2
Full Name of Owner 3
Accounts & Buying Contacts
Accounts Department Contact Name
Buyers Name
Declaration & Signature
Conditions:

1.Unless specifically changed in writing, the debtor acknowledges that credit facilities granted are payable strictly within 30 days from the day of the statement.

2. Credit facilities may be withdrawn by the creditor (United Eyecare) at any time without prior notice, and the creditor (United Eyecare) reserves the right to review the extent and duration of such facilities at any time.

3. If the buyer fails to make any payment by the due date, the seller (United Eyecare) shall be entitled to suspend any further deliveries to the buyer until all outstanding payments are brought up to date. The Seller (United Eyecare) may require payments in advance for any future deliveries.

4. All quoted or requested delivery dates are estimates only and the seller (United Eyecare) will not be liable for any delay in the delivery of the goods for any reason.

5. Claims for non-delivery or short delivery must be made within 21 days of receipt. The buyer confirms that this is a reasonable period to inspect the goods. Failure to notify the seller (United Eyecare) within this period will constitute acceptance of the goods.

6. Products supplied on credit remail the property of United Eyecare Ltd until paid for in full.

7. By signing this form, the customer agrees to be bound to the terms stated in this form.
Declaration Date*

MonthDayYear
Date
Declarant Name*
Declarant Signature*
Declarant Status*
I, the undersigned, acting on behalf of the debtor and being duly authorised thereto, do hereby warrant and agree that the above information is true and correct and further do hereby accept and agree to the conditions as set out above of which I acknowledge having read and understood.
Should be Empty:

New Account Form

Account & Business Details

Contact & Address Details

Business Background / Ownership

Accounts & Buying Contacts

Declaration & Signature