Application for Credit Account

Dereham Hire and Sales

Note: Items marked * are required fields.

Your Details

Your Name *
Company Name
Address *
Post Code *
Phone Number *
Fax Number
Mobile Number
Email Address *
Maximum Anticipated Monthly Credit Required From Us *
Name Of The Person Responsible For Paying Our Account On Time *

References

Reference 1 Name *
Reference 1 Address *
Reference 1
Post Code *
Reference 1
Phone Number *
Reference 2 Name *
Reference 2 Address *
Reference 2
Post Code *
Reference 2
Phone Number *

Declaration By Application Seeking Credit

I am duly authorised by the applicant business to enter this agreement on its behalf. I agree that payment of your invoices will be made strictly in accordance with the credits terms stated thereon.

I recognise that if payment of your invoices is not made by the due date for payment it may result in the matter being referred to the Credit Protection Association for recovery of the invoice debt; if so, I agree to indemnify you against the costs of recovering the debt and interest as applicable.

I understand that you may authorise a search through credit reference agencies, which will keep a record of that search and may share that information with other businesses. It/they may also make enquiries about the directors/partners as applicable.

I authorise our bankers to provide an opinion as to our suitability for the requested account.

I have read, understood & agree to these terms and conditions *