New Account Application Form

BUSINESS DETAILS

Business Name*

Sole TraderLimited CompanyPartnership

Date Established

Your email

Registered Address

Company Registration No.

Telephone

Proprietor/Director Name

Proprietor/Director Address

Telephone (if different)

TRADE DETAILS

Trading Name (if different)

Retail Shop / OnlineRestaurant / TakeawayWholesalerOthers, please specify:

Trading Address if different

Telephone (if different)

VAT Number (if registered)

AWRS Number (if applicable)

*Please provide evidence of an alcohol license if you wish to buy alcohol products

PURCHASE CONTACT

DELIVERY INFORMATION

Delivery Address (if different)

Contact Person

Telephone / Email

Delivery Instructions

INVOICE DETAILS

Trading Name (if different)

Address (if different)

Email (if different)

ACCOUNT CONTACT

Contact Person

Telephone

Email

*How did you hear about us? (Required field)
FacebookInstagramGoogleOthers, please specify:

Products you interested in? (Required field)
VegetablesFruitsFrozenCondimentPasteCansDrinksSnacksRice, Noodles, FlourSauce, SeasoningsNon Food

Would you like to apply for a credit term with us? *If yes, please complete the Account Application Request below.
NoYes

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ACCOUNT APPLICATION REQUEST

TRADE REFERENCE 1 (complete if request credit)
Company Name

Company Address

Contact Person

Telephone

TRADE REFERENCE 2 (complete if request credit)
Company Name

Company Address

Contact Person

Telephone

TRADE REFERENCE 3 (complete if request credit)
Company Name

Company Address

Contact Person

Telephone

CREDIT APPLICATION (subject to approval)
Monthly Credit Request

BANK DETAILS (complete if request credit)
Bank Name

Account Name

Account Number

Sort Code

BANK REFERENCE CONSENT (complete if request credit)

I/we...authorise Thai Tana Ltd to carry out a status enquiry on the bank account above.

Print Name

Date

Signature below (Required field)

I/We can confirm have read and accepted the Terms and Conditions
Please read these conditions carefully as they are part of your agreement with us. Terms and Conditions.

Print Name

Title

Date

Signature below (Required field)