Credit Application Form

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Application for Credit Account Facilities at Coppard Plant Hire

Full Trading Name:
Registered Office:
Post Code:
Telephone No:
Fax No:
Contact Name:
Company Reg No:
No of Years Trading / Business:
Turnover last year (approx)

Invoice AddressOnly fill this section in if you require the invoices to be sent to a different address
Name:
Address:
Post Code:
Telephone Number:

Name, address and telephone number of Director/Proprietor/Major Shareholder, and if applicable Ultimate Holding Company:
Name:
Address:
Post Code:
Telephone Number:

Bank Name:
Bank Address:

Post Code:
Bank Sort Code:
Bank Code Number:
Account Number:
Amount of Credit required:	£

Please give name & address of insurers in respect of hire plant:
Name:
Address:

Two Credit References (where other accounts are held)
Company Name:
Telephone Number:
Company Name:
Telephone Number:

Have any directors or Shareholders of a company been involved with a company which has ceased trading for any reason
Answer: (YES or NO)
(if yes, please give details on a separate sheet)
Signatures

We / I apply for monthly credit with Coppard Plant Hire Ltd and agree to settle all accounts to terms. We / I understand that all hires are subject to Coppard Plant Hire Ltd Terms & Conditions. We / I hereby certify that the information herein is correct and truthful to the best of my knowledge.

Signature of Applicant:X

Print Name:

Date:

DIRECTORS PERSONAL PAYMENT GUARANTEE - APPLICABLE TO ALL LIMITED COMPANIES

In consideration of Coppard Plant Hire Ltd agreeing to supply credit, I/We, Director(s) personally guarantee to terms of all sums of credit hereafter give to the above company. I/We agree that my liability under this guarantee shall not be impaired or discharged by Coppard Plant Hire Ltd giving time or indulgence to the company. I understand that to rescind this guarantee, I mist give 30 days notice in writing, which must be acknowledged, to Coppard Plant Hire, and that I shall remain responsible for credit give up to and including the 30th Day.

Signature of Director: X

Print Name:

Date:

PLEASE PRINT AND FAX TO: 01892 667094

Thank you

A representative from Coppard will contact you to confirm if your account has successfully been opened an activated for you.
This application is in agreement with our Conditions of sale and hire.





Crowborough Branch Tel 01892 662777 Fax 01892 667094 info@coppard.co.uk www.coppard.co.uk		Godstone Branch Tel 01883 743322 Fax 01883 744441 info@coppard.co.uk www.coppard.co.uk

Non operated plant is based on a 40 hour - 5 day week all rates E & OE \| all prices + 10% non account customers