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Account Application Form

Apply Below

Account Contact Name

Company Full Name

Email

Phone

Telephone Number

Registered Address

Trading Address

VAT Registration Number

Date of Incorporation

Monthly Credit Required

£100 - 1,000

£2,000 - 5,000

£5000 - £10,000

Sales Contact Name

Sales Email

Accounts Email

Accounts Contact Number (if applicable)

Years Trading

Bankers Name & Address

Bank Account Name

Account Number

Sort Code

Please provide two trade references, include contact information

I/We apply herewith for credit facilities and wish to open a credit account with Ciaras Loos Ltd and authorise you to make necessary enquiries for that purpose. I/We agree to abide by your credit terms, i.e. payment on or before the last day of the month following the month in which your invoices are dated. Interest charges of 4% over the prevailing Royal Bank of Scotland Group base rate may be incurred for overdue balances.

I/We accept the insurance requirments and will ensure strict compliance.