Application for credit facilities.

To enable us to process your application efficiently and effectively, please complete all sections online, print out the completed form, sign and return. Alternatively, if you would like to complete the form by hand, please click on the file below to print off a blank copy.

Return to: Accounts Dept, Imexpart Limited, FREEPOST,Links 31, Willowbridge Way, Whitwood, Castleford, West Yorkshire WF10 5BR. No need for a stamp as it's freepost!

If you experience any problems with completing the form, please call: Lo-Call: 0845 60 50 404

Need to compelete by hand? Please click for form. (2.91mb)

Company Details

Company Name

Trading Name
(if different)

Year Commenced Trading

Invoice Address

Post Code

Tel No

Fax No

Company e-mail

Registered Office

Company Registration No
(Corporate Companies only)

Registered Office Address

Post Code

Statement Address

Statement Address
(if different)

Post Code

Fax No

Tel No

Delivery Address

Delivery Address
(if different)

Post Code

Fax No

Tel No

(If you have multiple delivery addresses, please include these on a separate list and attach to this application)

Sole Traders or Partnerships only (Please give the full names and private addresses of all individuals)

Title

Forename(s)

Surname

Date of Birth

Full Address

Postcode

How long at this address

Title

Forename(s)

Surname

Date of Birth

Full Address

Postcode

How long at this address

Key Contacts (Please list key personnel within your organisation with whom we would have a day to day contact)

Person Responsible for the Purchasing of Parts:

Title

Forename(s)

Surname

Tel No

Fax No

e-mail

Person Responsible for the Payment of our Accounts:

Title

Forename(s)

Surname

Tel No

Fax No

e-mail

Please tell us a little bit about your business:

Please indicate your type of business:

Type of Business

Do you issue official order numbers

Where did you hear about us?

Please state the exact quantity & model types of the vehicles you currently own / operate / repair (if applicable):

Total No. of Iveco:

Total No. of MAN:

Total No. of ERF:

Total No. of Mercedes:

Total No. of Renault:

Total No. of Scania:

Total No. of Daf:

Total No. of Volvo:

Total No. of Other:

Additional Information

We wish to apply for credit facilities with your company and we have read your standard terms and conditions of trade attached. We accept your conditions of trade including your payment terms, which are strictly nett 30 days. We reserve the right to request addtitional information for Trade References and your Bank details.

Signature:

Print:

Title:

Dated:

Signature:

Print:

Title:

Dated:

This application must be signed by a person duly authorised to do so, and in the case of corporate companies this must be a DIRECTOR, COMPANY SECRETARY or other person duly authorised by the company. The capacity of the signatory must be stated, i.e. DIRECTOR, COMPANY SECRETARY, MANAGER, OWNER or PARTNER, etc. In the case of partnerships ALL PARTNERS MUST SIGN.

We are a Data Controller under the Date Protection Act 1998 ("the Act") and comply with the data protection principles set out in the Act in relation to handling any personal data which you may provide to us to the extent that the Act requires. By signing this application you acknowledge and consent that we may provide access to and transfer data to financiers/credit reference agencies for the purpose of provision of their services to us in respect of credit reference searches, credit control and analysis (including credit scoring, market, product and statistical analysis), provision of security and protection of our commercial interests. Any financiers/credit controllers to whom disclosure is made will keep and transfer the data only for the purposes stated. Details of our financiers and any credit reference agencies used will be made available upon request.

STEP 1 - PRINT

Print this Form

STEP 2 - SUBMIT INFORMATION

To enable us to process your application efficiently and effectively, please complete all sections online, print out the completed form, sign and return to: Accounts Dept, Imexpart Limited, FREEPOST,Links 31, Willowbridge Way, Whitwood, Castleford, West Yorkshire WF10 5BR. No need for a stamp as it's freepost!

If you experience any problems with completing the form, please call: Lo-Call: 0845 60 50 404

FOR OFFICE USE ONLY

ACCOUNT NUMBER

Date Received:
Area:		Postcode:	Initials:
Terms:
Application Successful:	Yes: No:	Authorised by :	Date: