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Credit Account Application
Application for Credit Facilities
Customer Details
Registered Name :
Registration Number :
Trading as (if different) :
Nature of Business :
Registered Address :
Tel :
Fax :
Postcode :
E-mail :
Principal Directors (Please include home address)
Name
Home Address
Postcode
Name
Home Address
Postcode
Name
Home Address
Postcode
Address for Accounts (if different from above)
Postcode
Person responsible for Payment of Accounts
Tel
Are you part of a Group of Companies
Yes
No
If yes, which
VAT Registration Number
Bank Details
Bank
Account Name
Address
Account Number
Tel
Sort Code
Trade References - PLEASE SUPPLY A MINIMUM OF 2
Name1
Name2
Address1
Address2
Postcode1
Postcode2
Contact Name1
Contact Name2
Tel1
Tel2
Fax1
Fax2
Do you have an insurance policy covering hire plant
Yes
No
If yes, please supply insurers name and policy number
Please provide details of insurance cover held
Employers Liability
Limit of Indemnity
Expiry Date
Public/Products Liability
Limit of Indemnity
Expiry Date
Credit
– Our Terms require that payment be made by the end of the month following invoice
Will you be trading with us on a regional or national basis.
Regional
National
Credit Limited Required
Damage Waiver Cover Required
Yes
No
I hereby apply for Credit Facilities with Instant Hire Ltd. I confirm that this information is true and complete and I have the authority to open this account. I agree to be bound by Instant Hire Ltd Terms and Conditions which, together with this information, form the agreement. We may from time to time, undertake certain checks on you by consulting a licensed credit reference agency, trade references or bankers references for the purpose of establishing your creditworthiness, debt recovery or fraud prevention. The agency may record the search. You hereby give express consent for us to carry out such searches. No further notification will be given to you by us when we undertake such a search and we may do so at any time
I have read and understand the terms and conditions detailed above.
I am also authorised to complete this form.
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