Company Name


Registered Office Address

VAT Reg. No


Co. Reg. No

Phone No


Fax No

Invoice address If different

Email address for invoices and statements

Do you require us to demand a Purchase Order Number?


Amount of Credit required (€)

Buyer Contact Name


Phone No

Accounts Payable Name


Phone No

Bank Details


No. of years with bank


Branch Address

Trade Reference 1


Phone No


Contact Name (Trade Ref 1)


No. of years trading with this company

Trade Reference 2


Phone No


Contact Name (Trade Ref 2)


No. of years trading with this company

Agreement

I/We wish to apply to open a credit account with Dublin North Pws-roweld Ltd, and I/We agree to make payment net
monthly, such time to run from the date of issue of invoice. Nett monthly requires the purchaser to pay by the end of
the month subsequent to the month in which the invoice is issued. Title will remain the sole property of Dublin North
Pws-roweld Ltd, until such time as these monies have been paid in full.

Our Return Policy- Merchandise may be returned for exchange or refund within 28 days providing it is unused, clean
and complete in the original packaging with receipt/invoice. We regret that cut material and specially ordered
merchandise are non-returnable. We allow only 30 days credit from the end of month which is strictly enforced.

Company Stamp (optional upload)


Signed on behalf of applicant’s company


Position

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