Credit Application

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Company Information

Please tell us about your company.

Company Trading Name

Company Registration Number

VAT Registration Number

Credit Amount Requested £

Country of Incorporation

Accounts Payable Email

Annual Turnover for Previous Year

Company Trading Address

Address 1

City

ZIP / Postal Code

State / Province

Country

Registered Office

Address 1

City

ZIP / Postal Code

State / Province

Country

Details of two suppliers with whom you regularly trade who will act as a reference.

Reference Name 1

Company

Reference Email 1

Reference Name 2

Company

Reference Email 2

Officers and Authorised Representatives of the Company

Applicant and/or Officer 1

Position 1

Officer Contact Number 1

Officer Email 1

Officer 2

Position 2

Officer Contact 2

Officer Email 2

DECLARATION. I hereby sign to agree to VIDEO MANAGEMENT SERVERS Ltd Terms and Conditions of business and submit the above information for the purposes of opening a credit account.

Name

Position

Declaration to be signed by a director or head of finance

Date

Date

Please Tick

I agree to VIDEO MANAGEMENT SERVERS LTD Terms and Conditions