To apply for a credit account with KRM please fill in the following form, fields marked bold and with an asterisks are required:

If you would like to apply for a cash account please apply here.

SECTION 1 - APPLICANTS DETAILS
Trading Title/Full Name:*
Address:*
Postcode:*
How long at this address:	Years
Telephone:*
Mobile:
Fax:
Email:*
SECTION 2 - COMPANY DETAILS
Company Reg No.:*
Registered Office:*
How long has your company been trading:*	Years
Main business activity:
PROPRIETOR/PARTNERS/DIRECTORS DETAILS:
Full Name:* Address:* Previous Address if less than 2 years at present address: Full Name:* Address:* Previous Address if less than 2 years at present address: Full Name:* Address:* Previous Address if less than 2 years at present address: Full Name:* Address:* Previous Address if less than 2 years at present address: Full Name:* Address:* Previous Address if less than 2 years at present address: Full Name:* Address:* Previous Address if less than 2 years at present address: » Add Another Proprietor/Partner/Director
Previous Directorships / Partnerships, including disqualified:
PLEASE SUPPLY NAMES AND ADDRESSSES OF 3 COMPANIES WHERE YOU HOLD A CREDIT ACCOUNT:
1. Name:*
Address:*
Tel:*
Fax:
Contact Name:*
2. Name:
Address:
Tel:
Fax:
Contact Name:
3. Name:
Address:
Tel:
Fax:
Contact Name:
SECTION 3 - SELF BUILD DETAILS
PLEASE GIVE DETAILS OF PREVIOUS ADDRESSES, IF AT CURRENT LESS THAN 2 YEARS
Full Name:
Address:
Full Name:
Address:
Type of self build:	New build Extension Garage Refurbishment Other (please specify below)
Other:
If new build please give site address:
Employers name & address:
SECTION 4 - BANK DETAILS & ACCEPTANCE
Bankers Name:
Estimate of Credit Account per month:*	£
Have you previously held or been refused an account with this company? If yes, please give details:
Please state if we require an order no. from yourselves for the supply of materials yes no
I/We wish to apply for a monthly credit account at KRM B.S. LTD.
I/We agree to the terms and conditions of sale.
I/We authorise that KRM B.S. LTD. may make a search with a credit reference agency.
What factors were most influential in deciding to apply for an account: (Tick up to 3)
Location Delivery Service Prices Credit Facilities Recommendation Customer Service Stock & Product Range Other (please specify below)
Other:
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