Customer Credit Application Form

Customer Credit Application Form

Please complete and return to the branch you wish to purchase goods from:
Account No
(HEAD OFFICE ONLY)
Branch
Credit Required
TRADING DETAILS

(ALL BUSINESSES TO COMPLETE)
Business Name
Trading Title (if different)
Trading Address
Postcode (Trading Address)
Contact Name (Trading Details)
Telephone Number (Trading Details)
Please enter a valid phone number.Format: (000) 000-0000.
Mobile Number (Trading Details)
Please enter a valid phone number.Format: (000) 000-0000.
Email Address (Trading Details)
example@example.com
VAT Number
Date Established

MonthDayYear
Date
ACCOUNT DETAILS

(if different)
Invoice/Statement Address
Postcode (Invoice/Statement Address)
Contact Name (Invoice/Statement Address)
Telephone Number (Accounts Details)
Please enter a valid phone number.Format: (000) 000-0000.
Mobile Number (Accounts Details)
Please enter a valid phone number.Format: (000) 000-0000.
Email Address (Accounts Details)
example@example.com
Email Address for Invoices/Statements
example@example.com
LIMITED COMPANIES
Registered Address (if different from trading address)
Postcode (Registered Address)
Company Registered No.
Director 1 - Full Name

First NameMiddle NameLast Name
Director 1 - Date of Birth

MonthDayYear
Date
Director 1 - Home Address
Director 1 - Postcode
Director 1 - Tel. Number
Please enter a valid phone number.Format: (000) 000-0000.
Director 2 - Full Name

First NameMiddle NameLast Name
Director 2 - Date of Birth

MonthDayYear
Date
Director 2 - Home Address
Director 2 - Postcode
Director 2 - Tel. Number
Please enter a valid phone number.Format: (000) 000-0000.
BANK DETAILS
Bank Name
Bank Address
Bank Postcode
Sort Code
Account Number
TRADE REFERENCES
First trade reference business name
First trade reference business name
First trade reference address
First trade reference postcode
First trade reference contact name
First trade reference email address
example@example.com
First trade reference telephone number
Please enter a valid phone number.Format: (000) 000-0000.
Second trade reference business name
Second trade reference address
Second trade reference postcode
Second trade reference contact name
Second trade reference email address
example@example.com
Second trade reference telephone number
Please enter a valid phone number.Format: (000) 000-0000.
WHOLESALERS TRADE REFERENCE
Business Name
Business Address
Business address postcode
Business contact name
Business email address
example@example.com
Business telephone number
Please enter a valid phone number.Format: (000) 000-0000.
Declarations and Data Protection Notice
I / we confirm that the information given in this (Credit Account Application Form) is in all respects true and accurate.

I/we confirm that I/we have read and understood your terms and conditions of (Sales / Business) and I / we unconditionally accept that those terms and conditions shall be the only ones that apply to all sale contracts which I /we may conclude with you.

Data Protection Act 1998 Notice Words shown in italics are defined in the Data Protection Act 1998 ("the Act")Where I / we provide you with personal data , I / we understand that the data will be held securely in confidence and processed for the purpose of carrying out your wholesaling supply business and associated activities. In considering my / our application, I / we accept that you may consult with and disclose the data to credit reference agencies, bank, credit insurers and other responsible organisations outside your business that you have nominated ("third parties") and that such third parties may process the data.

I / we understand that Under the Act I / we have a right to know what data you hold on me / us if I / we apply to you in writing and pay the applicable fee. Could you please submit a copy of your company headed paper.

I / We have read the Standard Terms and Conditions of Sale and accept that these Standard Terms and Conditions of Sale and payment terms of 30 days end of month following invoice will apply to all transactions with your company.

I / We believe the above information to be correct to the best of my / our knowledge.

Sole trader & partnerships must be signed by proprietor:
Declaration - Signature
Declaration - Name
Declaration - Position
Declaration - Date

MonthDayYear
Date
Continuing Guarantee
NB - If the customer is a limited company / if the business has been trading less than 3 years, the continuing guarantee below MUST be signed by a director or secretary (in case of a limited liability company) or equity partner (in case of a limited liability partnership). It may also be required to be completed in other cases.

To The British Electrical & Manufacturing Company Limited t/a BEMCO:

In consideration of your agreeing to grant credit facilities to the company or limited liability partnership described above ("the Company")

I hereby unconditionallyguarantee the due and punctual performance and observance by the Company of its obligations herein and under your Condition of Sale, and agree to idemnify and keep you indemnified against and breach of non-observance thereof by the company.
Continuing Guarantee - Signature
Continuing Guarantee - Name
Continuing Guarantee - Position
Continuing Guarantee - Date

MonthDayYear
Date
Please select:
Terms & Conditions
METHODS OF PAYMENT

Bank:	Lloyds Bank, 15-21 Northumberland Street, Monument Mall, Newcastle upon Tyne, NE1 7AE
Acc. No:	01148589
Sort Code:	30-93-71
Remittance Email:	sales.ledger@bemco.co.uk
Debit Card Payment:	Can be made at HEAD OFFICE (0191 2790028 & 2305449) or via your branch. Alternatively, you can request a Payment Link.

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Customer Credit Application Form

TRADING DETAILS

ACCOUNT DETAILS

LIMITED COMPANIES

BANK DETAILS

TRADE REFERENCES

WHOLESALERS TRADE REFERENCE

Declarations and Data Protection Notice

Continuing Guarantee

METHODS OF PAYMENT