Application to Open a Credit Account

Please fill out the form below, print it out and then fax it to 0116 256 7122. Please complete all sections or this could delay your application. Remember to sign section two and include a recent utility bill.

Alternatively you can download, print and fill out the PDF version.

1. Business Details

Business name and address

 

Registered office address (Limited Company) or private address (Unlimited business)

 

Credit account details

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2. Proprietor, Partners and Directors

(Please note a signature is required by the following for this application to be processed. Sole Trader: A signature of the proprietor is required. Partnership: A signature from all partners is required. Limited Company or plc: A signature is required from a Director or the Company Secretary.)

     
 
     
 
     
 
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3. Bank Details

Please provide details of your bankers

 

Please give names and addresses of two firms supplying materials on credit who may be approached for references

 
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4. Confirm

Terms & Conditions

 
Please indicate if you are a:              

 

A copy of a recent utility bill(s) must accompany this application. Please also include a letterhead if available.