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Application for credit Facilities

Company Name

Company Registration Number

Company VAT Registration Number

Telephone Number

Fax Number

Delivery Address

Accounts Telephone Number

Buyers Email

Accounts Email

Contact Name for Accounts

Website

Invoice Address: (If same as delivery address, please state)

Bank Details:

Name

Company Secretary

Directors

Address

Please give Two current trading references:

Reference One

Reference Two

Telephone Number One

Telephone Number Two

Please enter the name of the person authorized to sign orders on behalf of your company

I/We request you to open an account in the name of

With a proposed credit limit of per month

Please note: in applying for credit facilities, any queries or disputes of invoices must be made in writing within 7 days of date of invoice.

All credit accounts opened with Kpec International will be given a 30 day account from receipt of invoice.

We believe that the information given above to be full & correct.

Print Name

Position