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TRILOGY JEWELLERS CC
|
Sunninghill 2157
|
Tel no:(012) 669 0998 Fax no: (012) 669 0539 http://www.trilogyjewellers.co.za This e-mail address is being protected from spambots. You need JavaScript enabled to view it
|
ACCOUNT APPLICATION
with
TRILOGY
(Herewith referred to as the CREDITOR)
by
____________________________________________________________ (FULL NAME OF APPLICANT)
(Herewith referred to as the DEBTOR)
FORM OF BUSINESS: (e.g. company with limited liability, partnership, sole trader, close corporation, etc.)
__________________________________________________________________________________
FULL TRADING NAME: ____________________________________________________________
POSTAL ADDRESS: ________________________________________________________________
DELIVERY ADDRESS: ______________________________________________________________
PERSON RESPONSIBLE FOR CREDITOR’S ACCOUNTS: ________________________________
BUYER’S NAME: ___________________________________________________________________
TELEPHONE NUMBER: (_______)____________________________________________________
FAX NUMBER: (_______)____________________________________________________________
REGISTERED OFFICE ADDRESS: ____________________________________________________
COMPANY REGISTRATION NO: _____________________________________________________
COMPANY VAT REGISTRATION NO: ________________________________________________
DATE BUSINESS ESTABLISHED: ____________________________________________________
NATURE OF BUSINESS & PRODUCTS: _______________________________________________
NAME, ADDRESS & TELEPHONE NO. OF AUDITORS: __________________________________
___________________________________________________________________________________
BANKERS: ________________________________________________________________________
ACCOUNT NUMBER: _______________________________________________________________
OWNERS/PARTNERS/DIRECTORS/MEMBERS OF CC – SHAREHOLDING PERCENTAGE:
|
NAME
|
I.D. NO. ______________________________ ______________________________ ______________________________ |
TRADE REFERENCES AND TELEPHONE NUMBERS: (at least three references)
|
NAME
|
TELEPHONE NO. ______________________________ ______________________________ ______________________________ |
ESTIMATED MONTHLY PURCHASES FROM THE CREDITOR: +- R_______________________
ANY FURTHER REMARKS: _________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
SIGNATURE ______________________________________
FOR AND ON BEHALF OF COMPANY
FULL NAME ______________________________________
DATE ____________________________________________
PLEASE FAX BACK TO (012) 669 0539
Member: Susan Joubert Vat: 4480185075