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Credit Account Application Form

PTI Express Credit Account Form

Company Details

Name of Company

Company Address

Company Postcode

Telephone

Fax

Email Address

Website

Registered Address

Registered address Postcode

Year of incorporation

Company registration number

VAT Number

Company secretary

Bank Details

Bank Name

Bank Address

Bank Postcode

Bank sort code

Bank account number

Trade references

Please list as much contact information as possible. Minimun required is Company name and telephone number.

First trade reference

Second trade reference

Contacts

Warehouse/Despatch

Customer Service

Accounts Dept

Declaration

Form completed by

Company Position

I confirm I am authorized to complete this form on behalf the company specified above.

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