Customer Information

Full Name / Trading Name:

Address:

Town / City:

Postcode:

Phone Number:

Fax Number:

Mobile No:

Email:

VAT No:

Number of Years Trading:

Type of Customer
(e.g. Landscaper, Gardener, Irrigation Contractor, etc):

Maximum Credit Limit:

Trade Reference 1

Name:

Address:

Town / City:

Postcode:

Phone Number:

Fax Number:

Account Number:

Contact:

Type of Business:

Trade Reference 2

Name:

Address:

Town / City:

Postcode:

Phone Number:

Fax Number:

Account Number:

Contact:

Type of Business:

Bank Details

Bank Name:

Address:

Town / City:

Postcode:

Sort Code:

Account No:

Account Name:

Limited and Public Companies - Please now complete Section 2 in full.

Sole Traders and Partnerships - Please now complete Section 3 in full.

SECTION 2

Company Registration Number:

Incorporation Date:

Directors Names:

Do you have a Parent or Holding Company?
(give details):

Holding Company Reg No.

Company Name

SECTION 3

Are you a Sole trader:

or a Partnership:

Proprietor(s) full name(s) and address(s) - if less than 3 years at current address please provide previous details:

Name:

Address:

Town / City:

Postcode:

Name:

Address:

Town / City:

Postcode:

Name:

Address:

Town / City:

Postcode:

Name:

Address:

Town / City:

Postcode:

Previous Address details if Applicable:

SECTION 4 - All Applicants

On submitting this form I / we acknowledge and accept the conditions of sale contained within of this credit application (see pdf form), which govern all transactions.

Position in Company:

Date of Application: