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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