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The Dealer's Distributor

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Account Application Form



How did you hear about Trust?:
Full Trading Name:
Choose one of the following: Limited
Partnership
Sole Trader
Company Registration No:
Full Address:
Post Code:
Telephone No:
Fax No:
Application Date:
Managing Director's Name:
Reg Office:
Post Code:


Sole Trader or Partnership please complete the following. If a limited company, please supply a Director's name.

Choose one of the folllowing: Limited
Partner No 1
Sole Trader
Full Name:
Home Address:
Post Code:
Telephone No:


Please enter details of Partner No 2 below

Full Name:
Home Address:
Post Code:
Telephone No:


Business Details

Date Business Established:
Type of Business:
Payments Contact:
2nd Contact:
Tel No (if different):
Email:
Bank Reference: Bank/BS
Address:
Post Code:
A/c:
Sort Code:
Name of Account:


Trade Reference 1

Name:
Address:
Post Code:
Telephone No:
Fax No:
Contact:


Trade Reference 2

Name:
Address:
Post Code:
Telephone No:
Fax No:
Contact:


Accountants Details

Name:
Contact:
Telephone No:
Email:
Date of year end:
Payment with Order ie Credit Card:
Or required monthly credit limit (£):


I/We confirm that I/we have read and accepted Trust's terms and conditions of sale.


Form completed by:
Director Partner Ownerr
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