How did you hear about us ? *
A/c no *
Company Name *
Address *
Telephone No *
Fax No *
Contact *
Email address *
Registered Office *
Company Registration Number *
No. of years trading *
Invoice Address *
Contact Name *
Purchase Ledger Supervisor *
Contact Tel Number *
Email address*
Accountants Name *
Accountants Tel Number *
If partnership/sole trader please supply names & Home Addresses *
Bankers Name *
Account No and Sort Code *
Trade Reference (incl. Full Address & Tel. No) 1 *
Trade Reference (incl. Full Address & Tel. No) 2 *
Credit Required PCM *
Nature Of Business *
Number of Other Branches *
We confirm that should credit be granted, we will comply with your credit terms of 30 days nett from date of invoice. Failure to comply with these terms of payment will result in credit facility being withdrawn. Goods are accepted for carriage under TDM's standard terms and conditions.
Sign below by writing your full name, by that you confirm the information provided above are true and correct.
Full Name *
For and on behalf of *
Date *
Position Held *
