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CREDIT ACCOUNT APPLICATION FORM.
Company Name:
Trading Name:
Address1:
Address2:
City:
PostCode:
 Phone:
 Fax:
 E-Mail Address:
Nature of Business:
No' of years Trading:
 Amount of Credit:
£
Principal Partners:
1.
2. 		Position:
1.
2.

Reference 1:
Name:
Address:

Tel:

Reference 2:
Name:
Address:

Tel:

Bank Details

Bank:
Address:
Tel:



I/We authorise Pemruse Ltd t/a INTACAB to conduct a personal investigation as may be considered necessary and we also authorise any credit reference agency to supply such information as may be required.
We acknowledge overdue accounts are subject to a service charge of 2% per month.

I am an authorised representative of the company named above.
Print Name:    Date:

Click Here to clear the Form.     Click Here to Send the Form.

All Major Credit Cards Accepted