Unit  8  ,  The  Links

Popham  Close
Hanworth
Middlesex
Vestatec  Distribution  Ltd TW13  6JE
Tel:  +44  (0)20  8867  2340
Customer  Information  &  Credit  Application  Form Fax:  +44  (0)20  8894  1840
Company  Details

Full  Company  Name

Vat  number Reg.Number

Trading  as

Address

Country Post  Code

e-­mail

Tel Fax

Delivery  Address
(if  different)

How  long  trading  at  present  address

Attachments  (Headed  Paper  sample  required)

Type  of  business Sole Partnership Limited

Registered  Office  Address

Credit  Requested Currency

Contact  Information

Owner Who  should  we  contact  with

Managing  Director Order  queries

Finance  Director Accounts  queries

WE  SEND  STATEMENTS  INVOICES  AND  PROFORMAS  BY  E-­MAIL

PLEASE  PROVIDE  AN  E-­MAIL  ADDRESS  FOR  THESE  TO  BE  SENT  TO Accounts  E-­mail

We  hereby  agree  that  this  information  is  correct

Signed Date

Print  Name Title

Supplier  or  Trade  references

1.  Name e-­mail

Address

Fax

2.  Name e-­mail

Address

Fax

Bank  Account  Details

Name

Branch

A/c  No Sort  Code

IBAN Swift

I  certify  that  the  above  information  is  accurate  and  correct  and  
I  agree  to  the  terms.  (Signature  of  dealer  does  not  impose  any
obligation  on  Vestatec  Distribution  Ltd  to  appoint  the  dealer)
yes
Please  tick  to  show  you  have  read  and  understood  terms  and  conditions  of  sale
Ownership  and  Management  Details

If  details  are  the  same  as  page  1  please  tick  this  box  and  simply  sign  and  date
Owner Who  should  we  contact  with

Managing  Director Order  queries

Finance  Director Accounts  queries

We  apply  to  open  a  credit  account  subject  to  Vestatec  Distribution  Ltd  terms  and  conditions  as  seen.    We  note  payment  is  due  by  the  
end  of  the  month  following  invoice  and  we  undertake  to  settle  our  account  in  accordance  with  these  terms,  with  which  we  agree.

Signed Date

Print  Name Title

(to  be  signed  by  an  authorised  signatory  or  principal)  Note:  Please  keep  a  copy  for  your  records  and  return  to  Vestatec  Distribution  Ltd

For  Vestatec  Distribution  Ltd  Use  Only

Terms  /  credit  approved Approved  by

Date

Sales  Rep. Vestatec  Distribution  A/c  No.

WE  WILL  MAKE  A  SEARCH  WITH  A  CREDIT  REFERENCE  AGENCY

WE  MAY  ALSO  MAKE  ENQUIRIES  ABOUT  THE  PRINCIPAL  DIRECTORS  /  PROPRIETORS  WITH  A  CREDIT  REFERENCE  AGENCY.