Account Application

DATE

Company Name

Agent

Address

Sales Manager

Town/City

Account Number

State/Country

Postcode

Website

Company Number

Bank Name

VAT Number

IBAN

Number of years trading

Swift

CONTACT NAMES

Name(s)

Telephone(s)

Email(s)

Title(s)

REFERENCE 1

Company Name & Account Number

Contact Name & Telephone Number

REFERENCE 2

Company Name & Account Number

Contact Name & Telephone Number

Invoice Address (if different from above)

Delivery Address (if different from above)

Delivery Terms

Payment Terms

Signed

Date