CapjaDocs - Account Application Form

Account Application Form

Full Company Name: An answer is required.

PLC / Limited / Partnership / Sole Trader: An answer is required.

Trading Address (Inc. Postcode) An answer is required.

Invoicing Address: (If different)

Landline Telephone: An answer is required.

Company Registration No:

VAT Registration No:

UTR Number:

National Insurance Number: (If solder trader/Partnership)

For the purposes of the VAT Reversal Scheme, please confirm if you are an “End User” - Yes / No

No Yes

1 - Trade Reference Name & Address: An answer is required.

1 - Trade Reference - Phone number An answer is required.

2 - Trade Reference Name & Address: An answer is required.

2 - Trade Reference - Phone number An answer is required.

Contact Details

Accounts Payable Contact: An answer is required.

Telephone: An answer is required.

Email: An answer is required.

Email Address for invoices (if different to above) An answer is required.

Operations Contact: An answer is required.

Telephone: An answer is required.

Email: An answer is required.

Bank Details

Bank Name: An answer is required.

Bank Address: An answer is required.

Sort Code: An answer is required.

Account Number: An answer is required.

Requested Credit Limit: An answer is required.

Authorisation

I/We confirm that we accept the general conditions of Sherrington Lifting Services Ltd and CPA conditions. By making the afore mentioned application I/we agree to abide by them in all matters relating to the supply of goods and services from Sherrington Lifting Services Ltd unless other terms have been agreed in writing. I/We also agree to supply a copy of our 'Hired in Plant' insurance policy and understand that failure to do so will result in a Subrogation Waiver charge of 16% of the net job price. Payment terms (unless otherwise agreed in writing): 30 days from invoice.

Payment terms (unless otherwise agreed in writing): 30 days from invoice date

(Bank Details for payment – Sort Code 09-01-29 Account 31065924)

Director’s Signature: An answer is required.

Print Name: An answer is required.

Date entry An answer is required.

Suites C, D, E & F 14th Floor The Plaza, 100 Old Hall Street, Liverpool, England, L3 9QJ

Tel. 0151 440 2204 Company Reg. 11574889