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Open Account
IMPORTANT NOTE: Orders will not be able to be invoiced to an open account until your application is approved. You may save an in-process order until your account has been approved, or pay with a credit card. Please allow up to 1 business day for your online account to reflect "Allow Terms" as a invoice option.

Please complete this application in full. If you have any questions, call 0800 66 33 55
Credit Information
Line of Credit Requested
Business Information
Business Name
d.b.a.
Address
City
Country
Postal Code
Phone
Fax
Email
Company Reg No
How would you like invoices, statements and letters be sent?
email fax post
Has the firm or any of it's Principals ever been bankrupt?
Yes No
If yes, explain.
Ownership Information
Ownership
Sole Ownership Partnership Limited NonLimited
Principal Name
Principal Title
Principal's years with business
Non limited Company Director ( Proprietors) Name
Address
Tel
Fax
Terms
Terms Net 30 days
Trade References
Provide two suppliers of major products or services.
Reference 1
Company Name
Company Phone
Company Fax
Reference 2
Company Name
Company Phone
Company Fax
Bank References
Bank Acct No.
Bank Name
Bank Phone No.
Bank Fax No.
Declaration
Applicant agrees to pay any collection and legal fees incurred to collect unpaid balance, including interest on the unpaid balance at 2% above the Bank of England base rate.

The undersigned as an inducement to grant credit warrants that the information submitted is true and correct. You are authorized to investigate the credit references listed above.
In addition a Dunn & Bradstreet report will be obtained.
Applicant's Name
Today's Date 21/11/2008
WEB SALE
INVENTORY CLEARANCE
 
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