Company Name *

First Name

Last Name

Registered Company Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Invoice Address:

(If different From above)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Purchasing Contact name:

First Name

Last Name

Type of business:

Sole Trader

LTD company

Limited liability company (LLC)

Partnership

Bank Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are Goods only to be supplied with a valid order number?

Yes

No

Declaration *

I/We wish to open a credit account with Taplins Plant Ltd and are authorised to do so

I/We agree to your payment terms of 30 days from date of invoice

I/We understand that any queries must be reported to the accounts office no later than the 15th day of the following month

I/We agree to abide by Taplin Plant Hire’s Terms & Conditions (CPA Model Conditions) (Copies are enclosed or are available on request

I/We agree to insure the equipment hired for Damage, Fire and Theft. That replacement value will be charged for those items lost, stolen or damaged beyond repair

By submitting this application you are giving your consent for Taplin Plant Ltd to make inquiries into the banking and business information supplied.