CREDIT APPLICATION FORM

Company Details

Company Name:

Trading Name (if different):

Registration Number:

VAT Number:

Type of Business:

Physical Address:

Postal Address:

Contact Details

Telephone Number:

Mobile Number:

Email Address:

Contact Person (Accounts Department)

Full Name:

Position:

Phone Number:

Email Address:

Directors / Owners Information

Director 1

ID Number:

Full Name:

Contact Number:

Director 2

Full Name:

Contact Number:

ID Number:

Banking Details

Bank Name:

Branch:

Account Name:

Account Type:

Trade References

(Please provide at least two suppliers you currently have credit with)

1. Company Name:

Contact Person:

Phone Number:

Email

2. Company Name:

Contact Person:

Phone Number:

Email

Credit Request Details

Payment Terms Requested:

Amount of Credit Required:

Terms and Conditions

1. An upfront payment of 50% of the total quoted amount is required before
any credit facility is granted or work is commenced.
2. The remaining balance will be placed on credit as per the agreed terms.
3. All accounts are strictly payable within 30 days from date of invoice unless
otherwise agreed in writing.
4. Late payments may result in suspension of services.
5. Interest may be charged on overdue accounts.
6. The applicant agrees to pay all legal and collection costs incurred in
recovering overdue amounts.
7. Information provided in this application will be treated as confidential

Company Details

Contact Details

Contact Person (Accounts Department)

Directors / Owners Information

Director 1

Director 2

Banking Details

Trade References

Credit Request Details

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