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LCD Projector Hire
0161 777 6477

Credit Account Application

Complete and submit this Credit Account Application Form.
Or download and fax (Fax: 0161 794 4204)

Fax back to

  Full Trading Name of Company
 Contact Name
  Telephone Number
 Fax Number


Web Address
Email Address


Registered Address


Invoice Address
  Post code
 Post Code


Type of company


Company Registration Number

VAT Registration Number

Please supply details of 2 suppliers that currently extend credit terms to your organisation
  Name

Address

Post Code

Telephone Number

Fax Number

Email address
 Name

Address

Post Code

Telephone Number

Fax Number

Email Address
 
  I confirm to the best of my knowledge that the information on this form is correct.  
   

 

Name

Signature (only on printed version)

 

 

Date

 

 
 
Applications will be assessed, usually within 3 days by the following criteria:
  • Your company must have been trading for at least 12 months.
  • Partnerships/ Sole traders will need to provide an up to date balance sheet( signed by accountants/ solicitors).
  • Previous credit references are provided and checked.

Details provided is for use by Impala Hire only
and will not be passed on to any third parties.


Impala Hire is a division of Impala (UK) Ltd.

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