Credit Account Application Form

Company Name:

Company Type: Limited Company Sole Trader Partnership

Address:

County:

Country: England Republic Of Ireland Northern Island Scotland Wales Other

Contact Name:

Telephone No:

Fax No:

Registration No:

VAT No:

Years trading:

Credit Required:

For your security a member of the Harbrine Accounts team will contact you to collect your bank details once your credit application has been approved.

Contact Name:

Address:

Telephone No:

Fax No:

Contact Name:

Contact Address:

Telephone No:

Fax No:

DECLARATION: I hereby submit the above information for the sole purpose of opening a Credit Account with Harbrine Limited. I acknowledge that all orders are accepted by Harbrine Limited in accordance with their terms and conditions and agree that my Company shall be bound by them in all transactions. Goods shall remain the property of Harbrine Limited until paid in full.