PrimeMix

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PrimeMix Ltd, Nether Compton, nr Sherborne, Dorset DT9 4PZ
Tel: 01935 389069 Fax: 01935 815699

APPLICATION FOR CREDIT

"ALL ORIGINALS MUST BE RETURNED NOT FAXED"

COMPANY TITLE: ……………………………………………………………………………………………

ADDRESS:……………………………………………………………………………………………………

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POST CODE: ………………………….….          TEL NO: …………………………….………………...

CONTACT NAME: ……………………………..……………..FAX NO: …………………….……………

ALL DIRECTORS’ NAMES: ………………………………………….…………………………………………

INVOICE/STATEMENT ADDRESS:…………………………………………………..……………………….

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COMPANY REGISTRATION NO: …………..…..   NATURE OF BUSINESS: …….……………...………….

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ESTIMATED AMOUNT OF PROPOSED BUSINESS:   …………………………….

IF NOT A LIMITED COMPANY, FULL NAME AND ADDRESS OF PARTNERS:

1)  NAME: ……………………………………..…..                        2) NAME: ………….……………………….

ADDRESS: ……………………………..………….                        ADDRESS: ………….……………………..

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CREDIT AMOUNT REQUIRED:  ………………….  PER MONTH

TRADE REFERENCES  (ONE OF WHICH MUST BE IN THE POOL TRADE)

1)      NAME & ADDRESS: ……………………………………………………………………………………...

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PHONE NO: …………………………………….                             FAX NO: ………………………..………...

2)      NAME & ADDRESS: ……………………………………………………………………………………...

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PHONE NO: ……………………………………..                        FAX NO: …………………………………..

I/We * have read and accept the terms and conditions of PrimeMix Limited.

SIGNED                        PRINT NAME                        POSITION                        DATE

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* If a limited company, a director should sign, otherwise all partners should sign.

Directors: H C C Gosling BS, J G W Ellis, M G Rearden FCA, P A Smith (Mrs) Company Secretary
Registered in England No 2176806.  Reg Office: As above address.
Unless otherwise stated all offers are made without engagement and are subject to the company's conditions of sale


PrimeMix

CONSENT FORM TO CUSTOMER BANK

 

I/We authorise ……………………………………………………………….…. Bank plc

Of (address) ……………………………………………………………………….

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Account No: …………………………………………..

Sort Code no: …………………………………………

To provide a status enquiry to PrimeMix Limited.

Signed: ……………………………………………..            Date: ………………………….

Full Name (please print): ……………………………………………………………………………………..

For and on behalf of: ………………………………………………………………………………………….

Address: …………………………………………………………………………………….………………...

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