| Application for Credit |
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Please fill in this form and send to our credit department by click the send button below when complete.
We will receive this form and on completion of our credit procedures notify you of the result with account number if approved
Back to book service or repair
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Type of Business
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| Company Details ( Trading name) |
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| Registered Name |
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| Postal Address |
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| Delivery Address |
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| Accounts Payable Contact |
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| Telephone Contact |
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Fax Number |
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| Email Address |
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| Details of Directors/Partners/Proprietors |
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Name |
Address |
Phone |
| 1. |
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| 2. |
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| 3. |
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| Credit References (minimum of three) |
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Company Name |
Contact |
Telephone No. |
| 1. |
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| 2. |
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| 3. |
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| 4. |
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| Other Details |
| Estimated Purchases Annuallly |
$ |
| Maxiumum amount of Credit required |
$ |
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I have read and accept Parts on Demand Terms & conditions relating to purchase and this a[pplication for Credit. |
| Please submit send to activate your request |
