J&S Plumbing & Heating Centre Ltd

413 LUTON ROAD, CHATHAM, KENT. ME4 5BH

Tel: 01634 300044 Fax: 01634 300347

ACCOUNT APPLICATION FORM

Name……………………………………………………………………………………………………………………………………………………………. Trading Name……………………………………………………………………………………………………………………………………………….. Full Address ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………… Postcode………………………………………………. Phone……………………………………….…… Fax……..……….………………………………. E-Mail……………….………………………….. Mobile………………………………………………………………………………………………………………….………………………………………. Name of Person Responsible for Payment of Account on time……………………………………………………………………… Trading Style (please tick the one that applies to you) Sole Trader……… Partnership…………………… Ltd Company………………. Ltd Company Number………………………. Have any of the principals (directors/partners/trustees/proprietor) been involved in a Liquidation/Bankruptcy/IVA/CVA/Receivership? YES/NO (delete as applicable) How long have you been established? …………………. Years ………………………….Months Will order numbers be mandatory? YES/NO (delete as applicable) Bank Name………………………………………………………………………………………………………………………………………………….… Address:..............……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………… Postcode ………………………………………………… Name of Account: ………………………………………………………………………………………………………………………………………................................. Account Number……………………………………………………….. Sort Code………………………………………………………………… Credit Limit Required: £………………………………… Please bear in mind that goods cannot be supplied to account which go over their requested credit limit.

Please supply proof of address, such as a utility bill and sample letter heading. Please supply details of 2 Trade References, giving full address, postcode, telephone and fax

numbers on your Company Letterhead.

I/We make this application to open a credit account with J&S Plumbing & Heating Centre Ltd. I/We understand that credit terms are that payment is due promptly at the end of the month following the date of invoice, and that if granted credit I/we agree to pay in accordance with these terms. I/We acknowledge and accept the J&S Plumbing & Heating Ltd Terms and Conditions of Sale. I/We hereby give authorisation for use of our details in order to obtain Bank and Trade references.

Signed………………………………………….……………………….. Print…………………………………………………………………………….. Signed………………………………………….……………………….. Print…………………………………………………………………………….. Signed………………………………………….……………………….. Print…………………………………………………………………………….. Signed………………………………………….……………………….. Print…………………………………………………………………………….. All partners/directors to sign and print please.