Thank you for asking us to open a credit account for you and we hope to be able to do so shortly.

Firstly, can you please supply the following information?

Please complete all fields using an "X" if you can not supply the information.
Company Name
LTD? Yes No
Trading Name (if different)
Company Registration Number
VAT Registration Number
 
Company Address
Address
 
 
Postcode
Phone Fax
 
 
Delivery Address (if different from the main address)
Address
 
 
Postcode
Phone Fax
 
Contact Details
 
Orders Accounts
Name Name
E-mail E-mail
Credit Limit Required £
(Please estimate monthly spend during a busy time of year)
 
References
We may need to check two trade references. Who would you like us to approach?
Name
Address
Postcode
Name
Address
Postcode
 
By submitting this form you confirm that you will pay our accounts (less any invoices in dispute) at the end of each month following date of invoice and also that you know that we retain title to all goods and services supplied until we have received full payment. Please be aware that in case of non-payment we are entitled to recover from you any tyre of the same description as one for which you have not paid us. Thank you.
I agree to these terms.
 
Click submit to send this form directly to us or print to print the form then fax to 0121 350 5792.
Thank you.