Credit Account Application

UAP Information







Company Information

Registered Office Address

Credit References

An e-mail address MUST be supplied – references will be requested for all new account applications.

Supplier 1

Supplier 2

Credit Limit

Please complete below your requested credit limit and anticipated monthly spend:

Declaration

I / We undersigned hereby apply for a trade credit account. I / We agree to pay the account by the end of the last working day of each month following the month of delivery in accordance with the Conditions of Sale, and acknowledge the receipt of the Terms and Conditions.

 

Please draw in your signature. Clear signature.

 

Please draw in your signature. Clear signature.