The form is designed to be filled in using Microsoft® Word®. Note that fields will automatically expand as you type; this is perfectly normal behaviour and the number of pages will automatically expand to suit.
The form may alternatively be printed out and filled in by hand. If filled in by hand please use black ink and block capitals wherever possible. Should the space provided under any question be insufficient please attach your response on a separate piece of paper.
Please give full and accurate answers to the following:
1)STATUS
- Is the applicant a: (please tick one box only)
Partnership Sole trader Other (specify): (Please go straight to 3)
2)LIMITED COMPANIES
- Full name of the company:
- Former names of the company since incorporation:
- Company registration number:
- Address of the registered office:
- Business address (if different):
- Directors full names:
Director Name: / Director Name: / Director Name: / Director Name:
Director Name: / Director Name: / Director Name: / Director Name:
- Company secretary’s full name:
- Names of former directors and company secretary who have held office in the company in the last three years. Please also give the reasons for their resignation:
Name: / Name: / Name: / Name:
Reason for resignation: / Reason for resignation: / Reason for resignation: / Reason for resignation:
3)SOLE TRADERS AND PARTNERSHIPS
- Please provide the full name, home address and telephone number of the principal (where Sole Trader) and every partner in the firm:
Name: / Name: / Name: / Name:
Home Address: / Home Address: / Home Address: / Home Address:
Telephone Number: / Telephone Number: / Telephone Number: / Telephone Number:
- There has been any change of address in the last three years, please give full details of former address:
Name: / Name:
Home Address: / Home Address:
Telephone Number: / Telephone Number:
4)BUSINESS DETAILS
- Full trading name of the business:
- Description of business:
- Business address:
- Business telephone number:
- Business fax number:
- Company purchasing contact:
- Purchase ledger contact:
- Period of time using the above trading name:
- Any other trading names used in the last five years:
5)BANK DETAILS
- Bank name:
- Branch address:
- Bank account number:
- Bank sort code:
6)TRADE REFERENCES (please provide a minimum of two current trade references)
- Please provide a minimum of two current trade references:
Name: / Name:
Address: / Address:
Telephone number: / Telephone number:
- Anticipated credit limit required:
7)PERSONAL INFORMATION
In respect of each of the individuals named please supply full details of:
- Any criminal convictions for any offence involving fraud or dishonesty:
- Any involvement in any capacity in any business which is failed due to insolvency:
- Any county court judgments within the last six years:
- Any insolvency proceedings or arrangements with creditors:
- Any other relevant facts which may affect your credit worthiness:
8)DECLARATION – valid only if signed by Director
In consideration of Printaply agreeing to grant credit facilities, I/we here undersigned hereby jointly and severally declare that:
a)I/we shall be personally responsible for all sums owing to you by the said company on payment being still outstanding two months from the date of invoice.
b)I/we guarantee payments by the said company of all sums owing by it to you in respect of credit allowed.
c)I/we shall stand as principal debtors to you in respect of outstanding monies.
d)Any forbearance or time given by you to the said company shall in no way affect my/our liability to you under this guarantee.
e)I/we acknowledge receipt of, and accept in full, the terms and conditions of sale of Printaply.
f)I/we confirm that accounts will be paid in full within 30 days of the end of the month of invoice.
Signature of applicant: / Name in block capitals: / Position in organisation: / Date:
Credit Account Application FormPage 1 of 4