| 1. Business Details |
| Trading Name: | .................................................................................................................... |
| Main Activity: | ....................................................................................................................
|
| Operating Address: | ....................................................................................................................
|
| Postcode: | ....................................................................................................................
|
| Telephone: | ....................................................................................................................
|
| Fax: | ....................................................................................................................
|
| |
| 2.
Limited Companies and PLCs only |
| Registered
Name: | ....................................................................................................................
|
| Co. Reg No: | ....................................................................................................................
|
| Years incorporated: | ....................................................................................................................
|
| Registered Address: | ....................................................................................................................
|
| Postcode: | ....................................................................................................................
|
| Would directors sign a personal
guarantee: | Yes / No (please
circle) |
| |
| 3.
Sole Trader or Partnership (please circle) |
| Partner 1 | |
| Full Name: | ....................................................................................................................
|
| Home Address: | ....................................................................................................................
|
| Postcode: | .................................................................................................................... |
| Telephone Number: | ....................................................................................................................
|
|
| Partner
2 | .................................................................................................................... |
| Full Name: | ....................................................................................................................
|
| Home Address: | ....................................................................................................................
|
| Postcode: | ....................................................................................................................
|
| Telephone Number: | ....................................................................................................................
|
|
| Partner
3 (if applicable) | .................................................................................................................... |
| Full Name: | ....................................................................................................................
|
| Home Address: | ....................................................................................................................
|
| Postcode: | ....................................................................................................................
|
| Telephone Number: | .................................................................................................................... |
|
| Partner
4 (if applicable) | .................................................................................................................... |
| Full Name: | ....................................................................................................................
|
| Home Address: | ....................................................................................................................
|
| Postcode: | .................................................................................................................... |
| Telephone Number: | ....................................................................................................................
|
|
| Partner
5 (if applicable) | .................................................................................................................... |
| Full Name: | ....................................................................................................................
|
| Home Address: | ....................................................................................................................
|
| Postcode: | ....................................................................................................................
|
| Telephone Number: | ....................................................................................................................
|
| |
| 4.
Accounts Information |
| Address
for Accounts: (if different from above) | ....................................................................................................................
|
| Postcode: | ....................................................................................................................
|
| Do you hold an insurance policy
covering hired plant? | Yes / No
(please circle) |
| If
Yes, please supply insurers name and policy: | ....................................................................................................................
|
| Accounts Telephone Number: | ....................................................................................................................
|
| Do you require accidental damage
waiver on small tools: | Yes / No
(please circle) |
| Monthly
Credit required: | ....................................................................................................................
|
| Person responsible for payment
of account: | ....................................................................................................................
|
| |
| 5.
Trade References |
| Name 1: | ....................................................................................................................
|
| Address: | ....................................................................................................................
|
| Postcode: | .................................................................................................................... |
| Telephone Number: | ....................................................................................................................
|
| .................................................................................................................... |
| Name 2: | ....................................................................................................................
|
| Address: | ....................................................................................................................
|
| Postcode: | ....................................................................................................................
|
| Telephone Number: | ....................................................................................................................
|
| |
| 6.
Bankers Details |
| Bank Name: | ....................................................................................................................
|
| Branch Address: | ....................................................................................................................
|
| Sort Code: | ....................................................................................................................
|
| Account Number: | ....................................................................................................................
|
| |
| 7.
Declaration |
| I, being an authorised
official of the above business hereby apply for credit facilities with NATIONWIDE
TOOL HIRE LTD. I confirm that this information is true and complete and
I agree to the bound by the terms and conditions of trading. |
| Signed: | .................................................................................................................... |
| Name: | .................................................................................................................... |
| Date: | ....................................................................................................................
|
| Position: | ....................................................................................................................
|
| |
