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Account Registration

Legal Entity:

Trading Name:

Company Registration Number:

Vat Reg. No.

Contact Person:

Telephone Number:

Cell Number:

Fax Number:

Email:

Physical Address:

Postal Address:

Name of auditor:

Auditors address:

Trade Style

Public Co.

Private Co.

Partnership

Sole Proprietorship

Government

Close Corporation

Full Name/s of Director/s, Shareholder/s, Principal Owner/s, Partner/s

Name

ID No

Residential Address

Capacity

1.

2.

3.

4.

Bankers:

Branch:

Account No:

Trade References (minimum of 2):

Name

Address

Tel No:

1.

2.

3.

4.

Total credit facility required: R

Terms: 30 days from date of statement

The Purchaser -
1. Acknowledges that the entered information will be relied upon by the supplier in granting credit and consents to the supplier making any enquiries it deems neccessary to verify and amplify the information;
2. Accordingly certifies that the entered information is true and correct in each and every respect;
3. Acknowledges that the credit facilities granted by the supplier, if any, shall be at the sole discretion of the supplier, particularly with reference to the nature, duration and extent thereof, and security required;
4. Accepts and undertakes to be bound by the general terms and conditions of purchase set out overleaf, which terms and conditions of the purchaser acknowledges having read and understood and agrees will be applicable to all transactions, relating to the purchase of goods by the purchaser from the supplier;

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