Account Application
Unit 26, Millshaw Park Industrial Estate, Millshaw Park Drive,
Leeds, LS11 0LR.
Tel: 08456 444 906 Fax: 08456 444 668
Email: sales@dwn-uk.com Web: www.dwm-uk.com
Date: ..........................................................
Name of Company/Business:
Trading Name (if different): .............................................................................................................................................
Address: .....................................................................................................................................................................
.........................................................................................................Post Code: .................................................
Telephone No: ................................................................... Fax No: ..........................................................................
Email: .........................................................................................................................................................................
Numbers Of Years Trading: .......................................................................................................................................
Company Registration No:........................................................ Vat No: ....................................................................
Type Of Business: ......................................................................................................................................................
Business Status: Limited Co / Sole Trader / Partnership / other ........................................................................
Directors / Proprietors / Shareholders:
Name(s):
1: ...............................................................................................................................................................................
2: ...............................................................................................................................................................................
3: ...............................................................................................................................................................................
4: ...............................................................................................................................................................................
Date Business Established: ......................................................................................................................................
Bank Details
Bank Name: ................................................................................................................................................................
Address: .....................................................................................................................................................................
........................................................................................................................................Post Code: .........................
Account No: ........................................ SortCode: ....................................... Credit Required: £ .............................
Office Use Only
Trade References:
1, Name: ................................................................................
Type Of Business: .............................................................
Contacted: ................................................
Address: ............................................................................
Replied: ....................................................
...........................................................................................
Post Code: ........................................................................
Telephone: ........................................................................
Fax: ...................................................................................
Email: ................................................................................
Credit Limit: ......................................................................
2, Name: ................................................................................
Type Of Business: .............................................................
Contacted: ................................................
Address: ............................................................................
Replied: ....................................................
...........................................................................................
Post Code: ........................................................................
Telephone: ........................................................................
Fax: ...................................................................................
Email: ................................................................................
Copy of Letterhead Attached:
I/We apply for opening of a credit account and declare the above details to be correct. I/we confirm receipt and acceptance of Direct Wholesale Marketing General Conditions of Trade.
Authorised Signatory: .......................................................................................................
Print:
Name: ...............................................................................................................................
Position: ...........................................................................................................................
Date: ................................................................................................................................