CREDIT APPLICATION
Full Company Name & Address of applicant: *
Your answer
Phone no: *
Your answer
Fax No
Your answer
Email Address *
Your answer
Date business established:
Your answer
Name of parent organisation:
Your answer
Trading style (if different):
Your answer
Type of business organisation: *
Ltd co. registration no:
Your answer
Registered office address:
Your answer
VAT Registration No:
Your answer
Address for invoices/statements if different from above:
Your answer
Name & address of owner/partners:
Your answer
Name & address of directors (if Ltd co. trading for less than 2 years):
Your answer
Name of payment contact:
Your answer
Tel no:
Your answer
Email address (for pdf statements/invoices):
Your answer
Estimated value of monthly purchases:
Your answer
Currency: *
Tata Chemicals Account Manager if known *
Product *
Name & Addresses of trade reference able to speak for this level of business 1.
Your answer
Name & Addresses of trade reference able to speak for this level of business 2.
Your answer
Bank Details Name
Your answer
Account Name
Your answer
Sort Code
Your answer
Account number
Your answer
Bank Address
Your answer
Position in Company *
Your answer
I accept and agree to comply with your advised payment terms. I accept and agree that Tata Chemicals terms and conditions shall apply to all transactions between us unless otherwise agreed by both parties in writing. I give my consent to a credit search made on me/us as owners/partners or directors of this organisation both now and at any future date. I understand this search will be recorded by the agency and may be disclosed to subsequent enquires
Submit
Never submit passwords through Google Forms.
This form was created inside of Tata Chemicals Ltd. Report Abuse - Terms of Service - Additional Terms