Credit Application Form

CREDIT APPLICATION FORM

CUSTOMER DETAILS

Type of Business

Limited Company

Partnership

Sole Trader

Trading Name

Trading Address

Invoice Address

Who is your contact at Sortera?

How did you hear about us?

Registered Office Address (If different from Invoice Address)

Registration Number

Incorporation Date

VAT Number

SIC Code

Parent Company Name (If applicable)

Principal Name (If Partnership or Sole Trader)

Principal Address (If Partnership or Sole Trader. Please also attach copy of recent utility bill)

DETAILS OF INDIVIDUALS AUTHORISED FOR BUSINESS TRANSACTIONS

Name

Business Title

Name

Business Title

FINANCE CONTACT – ACCOUNTS PAYABLE

Contact Name

Telephone

PROCUREMENT/BUYING CONTACT

Contact Name

Telephone

BANK REFERENCE

Bank Name

Account Name

Sort Code

Account Number

Bank Address

TRADE REFERENCES

Company 1

Contact Name

Address

Postcode

Telephone

Account Opened Since

Credit Limit

Current Balance

Company 2

Contact Name

Address

Postcode

Telephone

Account Opened Since

Credit Limit

Current Balance

CREDIT REQUIRED

Estimated Total Purchases Per Year £

Maximum Credit Required Monthly £

Please confirm the services you will require

Skip Hire

Muck/Grab Away

Transfer Stn/Tipping Facilities

Hazardous Waste Services

PURCHASING PROCEDURE

Any Purchasing Procedure or Conditions, e.g. Purchase Orders? Please specify

We apply for monthly trading credit facilities with Sortera in accordance with the Company's terms and conditions of sale, and agree to settle all accounts no later than the 30th day of the month following date of invoice.

We hereby authorise you to make enquiries relating to our credit standing as you consider necessary, and to check the bank and trade references we have supplied.

Authorised Signatory

Name

Title

Date

For questions or assistance completing our credit application, call 0330 0 944 944 or email accounts@sortera.co.uk