New Account Application Form

Business Details

    BUSINESS DETAILS


    Date Established

    Telephone

    Proprietor/Director Name

    Proprietor/Director Address

    Telephone (if different)

    TRADE DETAILS

    Trading Name (if different)


    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)

    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.

    ...........

    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 confirm that I/We have read, understood, and accept the terms and conditions attached to this form.

    Print Name

    Title

    Date

    Signature below (Required field)