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Monthly credit account application

Strictly Confidential

Details of the Business applying for credit (referred to in the remainder of this form as the “Applicant Business”)

Where the applicant Business is a limited company, we require a Guarantee and Indemnity from the
director(s) of the applicant Business

Full Names And Addresses of all directors and (if any) the company secretary (if limited company) or of all partners (if a partnership) or of the sole trader (if a sole trader)

Bankruptcy / Insolvency History

Have any of the above individuals been declared bankrupt or been involved either as director or shareholder with a company which has been wound-up or is the subject of insolvency proceedings? (if yes, please give details)
Does the Applicant Business or (i) any of its directors or secretary (ii) any of its partners or (iii) the sole trader him/herself have any county/high court judgements pending or registered against it/them? (if yes, please give details)

Parent / Holding Company Details

Bank Details

Trade References

Credit Amount

Contact Name for account queries

Thank you! We’ll be in touch.

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