CUSTOMER ACCOUNT APPLICATION FORM (Application for ?· CUSTOMER ACCOUNT APPLICATION FORM (Application…

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    04-Jun-2018

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  • The Former Bus Depot, Moulsecoomb Way, Brighton, East Sussex, BN2 4PN Tel: 01273 608711

    Fax: 01273 608712 info@ksdenvironmental.co.uk

    CUSTOMER ACCOUNT APPLICATION FORM

    (Application for a credit account our terms are 30 days from date of invoice)

    Customer Details

    Full Business Name:.

    Address: .

    .

    Post Code: .. Contact Name: Email:

    Nature of Business: ...............................

    Company Registration Number:... VAT Number: ..

    Account Type: Skip Hire [ ] Waste Disposal [ ] License No..

    *Please send copy of Public Liabilities insurance on return with completed form

    Invoice Details To whom, and where are we to send our invoices to?

    Full Business Name: .

    Address: .

    .

    Post Code: .. Contact Name: . Tel:.....................

    Fax: . Email (Invoices & Statements will be sent here).

    Bank Name/Address: ..................................

    ..

    Bank Account Name: .. Sortcode: . ACC No:

    Do you require Purchase Order numbers on all invoices? Yes [ ] No [ ]

    Trade Reference - Please supply 2 full referees

    Supplier Name: . .. Supplier Name:

    Address: Address:

    ... ..

    Telephone No: Telephone No: ..

    Contact Name: .................... Contact Name: ................

    Email: . Email: ..........

    AUTH COMPANY SIGNATURE:.. PRINT: .

    Official use only

    4yd 6yd 8yd 10yd 12yd RO/RO Haulage Tonnage

    Weighbridge Disposal Charge Min Charge

    Account Approved [ ] Account Rejected [ ] Signature:

    Tel:

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