Jot form

First name *

Surname *

E-mail *

Role *

Telephone (direct line) or mobile number *

Company name *

Does the company trade under a different name? *

Yes No

Trading name *

Company telephone number

Invoicing address *

Trading / delivery address *

Same as above Another address

Trading / delivery address *

Company type *

Limited company Partnership Sole trader Other

Please specify company type *

Company registration number *

VAT number *

Part of subsidiary? *

Yes No

Parent company name *

Is the company authorised to obtain goods and services at the zero rate of VAT? *

Yes No

Please attach a copy of Form VAT 13B (if applicable)

Do you require credit? (Please note: if you select 'no', you'll be setup with a prepaid cash account, payment prior to dispatch) *

Yes No

Credit terms are generally only available after a period of pro forma prepaid trading, and after a certain level of business has been achieved. *

Yes, we'd like to proceed with a Credit Application. No, we don't require credit at this time. A prepaid cash account is sufficient.

Names and positions of company directors *

Issued capital

Years traded *

Does the company have any County Court Judgements registered against it? *

Yes No

Please provide details of County Court Judgements *

Premises

Leasehold Freehold

Please attach a photo or scan of the company letterheaded paper

Please attach the latest signed audited accounts (if available)

Please state annual turnover for each of the last 3 years *

Maximum monthly credit required *

Currency *

Accounts contact *

Accounts contact phone number *

Accounts contact email *

Bank name

Bank address

Bank telephone number

Bank sort code

Bank account number

Number of years this bank has held the company account

To offer credit terms, we will require two trade references. Some companies don't issue trade references, so please double check before listing a company in this section. *

Ok

Trade reference 1: Company name *

Trade reference 1: Company address *

Trade reference 1: Contact person, email, and phone number *

Trade reference 2: Company name *

Trade reference 2: Company address *

Trade reference 2: Contact person, email, and phone number *

By submitting this form, you hereby certify that:

Confirmation that you agree to the above terms and conditions *

I agree

Contact

Company

Credit Application

Bank details

Trade references

Trade reference 1

Trade reference 2

Agreement

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Contact

Company

Credit Application

Bank details

Trade references

Trade reference 1

Trade reference 2

Agreement

About

How can we help

Shopping with us

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