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INSIGNIA IT CREDIT APPLICATION
Company Details
*
Indicates required field
Company Name
*
Trading Name (if applicable)
*
Company Registration Number
*
Business Type
*
Limited
Non-Limited
PLC
Public Sector
Registered Address
*
Line 1
Line 2
City
State
Zip Code
Country
Main Telephone Number
*
Business Activity
*
Website
*
Position
*
Name of Accounts Contact
*
First
Last
As part of our environmental policy, we try to negate sending hard copy invoices as much as possible. The email stipulated here will receive all accounts related collateral electronically.
Accounts Phone Number
*
Accounts Email
*
VAT registration
*
Account Type
*
Credit Account
Credit/Debit Card
Bank Transfer
For credit accounts, our standard payment terms are strictly 30 days from date of invoice Please note that all card transactions will levy a 2.5% payment processing fee, which will be clearly enlisted within all sales quotations generated
Credit Limit Required (£) (for credit accounts)
*
Trading Address (If different from Registered)
*
Line 1
Line 2
City
State
Zip Code
Country
Please click
HERE
to review our terms and conditions
Please tick the following box where prompted to confirm that you hereby agree to the INSIGNIA IT terms and conditions of sale. You must be an authorised signatory and confirm that the details provided in the application form are accurate and complete. Submission of this online form constitutes applying an electronic signature.
Acceptance of INSIGNIA IT "terms of sale"
*
I accept the INSIGNIA IT "Terms of sale"
Please tick the box to confirm your acceptance of the INSIGNIA IT "Terms of sale"
For and behalf of (insert company name)
*
Print Name
*
First
Last
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