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Application for credit facilities

Deliveries to:
Name
Address
Tel number
Fax number
Email address
VAT registration no
Statement to: (if different to above)
Contact name
Address
Tel number
Fax number
VAT registration no
Bank details
Length of time in business
Bankers name and address
Bank account no
Estimated monthly credit required
Please supply the names and addresses of 2 companies with whom you trade regurlarly

Contact 1

Contact name
Contact address
Tel number

Contact 2

Contact name
Contact address
Tel number