Online Credit Application Form

Please fill in the form below: (* indicates mandatory fields)

 

ONLINE CREDIT APPLICATION FORM

Company Trading Name

Address

Registered Office Address (if different from trading address)

Hire Details

Hire Contact

Tel

Fax

Email

Accounts Details

Accounts Contact

Tel

Fax

Email

Business Details

Are trading premises Owned/Rented

Nature of Business

Date Established

If Limited company, Registration No

If not limited please supply full name and address of proprietor/partners

UTR Number

Do you normally issue order numbers

Yes
No
BANK DETAILS

Name Of Bank

Address Of Bank

Sort Code

Account No

Two Trade References (one of which must be a plant hire company)

Supplier 1

Name

Address

Tel No

Fax

Nature Of Business

Supplier 2

Name

Address

Tel No

Fax

Nature Of Business

CREDIT LIMIT REQUESTED

Credit Required (£)

We apply for trading credit facilities with Flannery Plant Hire Ltd in accordance with the Company?s terms and conditions of sale, and agree to settle all accounts no later than the 30th day of the month following date of invoice.

We hereby authorise you to make enquiries relating to our credit standing as you consider necessary and to check the bank and trade references we have supplied.

Our terms and conditions state the hirer is responsible for loss or damage. Are you insured?   Yes No
Broker Contact Details for

Hired-in Plant Insurance

Insurer

Address

Policy Number

Public & Products Liability Insurance

Insurer

Address

Policy Number

 

Signature

Date

Print Name

Position Held


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CPA TERMS AND CONDITIONS APPLY

ACCOUNTS ARE STRICTLY 30 DAYS


ACCREDITATIONS