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					<company logo>
<company address>
<company address>
<company address>

                  Credit Application Form / Debtor Information
Full Company Name: ………………………………………………………………………………….
Physical Address: ………………………………………………………………………………………
              ………………………………………………….. Code ……………………………
Postal Address: ……………………………………………………………………………………….
              ………………………………………………….. Code ……………………………
Tel no: ………………….……… Fax no: ……………………….. Cell: ……………………………..
E-mail: ……………………………………………….. Accounts Contact: …………………………..

                         Company Registration Details
Sole Trader   /      CC/CK /      (Pty) Ltd
CC/CK no: …………………………………………… (Pty) Ltd no: ………………………………….
VAT no: …………………………………………………………………………………………………

                  Directors / Members / Sole Traders Names
Name: ………………………………………………….. ID no: …………………………………………
Home Address & Tel no: …………………………………………………………………………………
…………………………………………………………………………………………………………….
Name: ………………………………………………….. ID no: …………………………………………
Home Address & Tel no: …………………………………………………………………………………
……………………………………………………………………………………………………………..
Name: ………………………………………………….. ID no: …………………………………………
Home Address & Tel no: …………………………………………………………………………………
…………………………………………………………………………………………………………….

                                Bankers Details
Bank Name: ……………………………………………………………………………………………….
Branch: ……………………………………………… Branch Code: ……………………………………
Account Number: ……………………………………………… Auditors: ……………………………...

                               Trade References
Company: ……………………………………………………….. Tel no: ……………………………….
Company: ……………………………………………………… . Tel no: ……………………………….
Company: ……………………………………………………….. Tel no: ……………………………….
………………………………………… FOR OFFICER USE ONLY …………………………………
Client Approved: …………………………….             Client Declined: ……………………………….
Signature: …………………………………………………………………….

				
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posted:12/7/2009
language:English
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Description: company logo