Application For Credit Account

Company Contact Information

Company Trading Name *

Full Address *

Postcode *

Contact Name/s

Telephone

Email

Accounts Name/s *

Accounts Telephone *

Accounts Email *

Company Details

Company Registration Number *

Date of Incorporation

VAT Registration Number *

Director's Name

Director's Name

Director's Name

Banking Details

Bank Name *

Bank Address *

Postcode *

Sort Code *

Account Number *

Trade References

Name *

Address *

Postcode *

Telephone *

Email *

Name *

Address *

Postcode *

Telephone *

Email *

Credit Limit

Credit Limit Requested *

All first orders are dealt with on a pro-forma basis.
Subject to a satisfactory credit check, credit terms are strictly 30 days from date of invoice.

By submitting this form, the person named beneath states that all the above information is true and agrees to abide by LSi's terms & conditions.

View our terms & conditions (opens in a new tab)

Name *

Position *

Date *

I agree to abide by LSi's terms and conditions *

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