Customer Application Form Business Contact Information Name Position Company Name Company Registration No Telephone No Email address VAT Registration No Registered Address Postcode Date Business Commenced Type of Business Legal form under which the business operates in Business & Credit Information Bank Name Sort Code Account No Type of account Credit Amount Required Bank address 1 Business Trade References Company name Phone Email address Address 2 Business Trade References Company name Phone Email address Address Agreement 1. All invoices are to be paid within 30 days of the date of invoice 2. Claims arising from invoices must be made within 7 days 3. By submitting this application form you authorise MRMS to make enquiries to bank & business references that have been supplied Signatures Signature Name & Title Date Signature Name & Title Date Δ