BUSINESS DETAILS Limited Company / PLC
Non-Limited / Partnership / Sole Trader / Personal
Company Name:
Trading Name:
Trading Name:
Date of Birth: Homeowner
Trading Address:
(If different from above)
Company No:
Tenant
Please provide recent utility bill with completed Application Form Postcode:
Trading Address:
Time at Present Address:
Years
Months
Partnership? Please provide Full Names, Addresses and Date of Birth of All Partners on a separate sheet of paper.
Postcode:
Our payment terms are monthly account, payable by the end of the following month. E.g. August goods A/C payable at the end of September.
CONTACT DETAILS Your Name:
Your Tel. Number:
Accounts Contact Name: (If different)
Your Email:
Your Mobile Number: Accounts Contact Number: (If different)
Invoice Address:
Postcode:
(If different from above)
Please inform us of any special instructions:
Accounts Contact Email:
i.e. Order Number or Pass Phrase required?
(If different)
Receiving Invoices/Statements. We send documents via email but if you require postal invoices instead please tick here □
The Accounts Contact is who we will contact to discuss the account, send invoicing/statements to and also provide access to our account portal (pochin.com)
Account Portal. We’ll set the provided email addresses up on our Account Portal where documents can be accessed and payments made.
AREA OF WORK Boiler servicing repairs & installs Gas
Both
Oil
N/A
REFERENCES
Renewables & underfloor heating installer Yes
Work type
No
Supplier 1:
Domestic
Both
Contact Number:
Commercial Supplier 2:
General building/ property maintenance Yes
General plumbing/ bathroom installation
No
Yes
Contractor
No
Yes
Contact Number:
No
SIGNATURE By signing this agreement you accept that:
Signature:
a) You have read and understood our Terms & Conditions as detailed on the back of this form and agree to respect the credit terms stated. These may be varied by us from time to time. b) The information given by you is correct and we may rely on it. c) You are authorised to bind the Account Holder to this agreement by signing it. d) You authorise us to apply to either or both of the above supplied Trade References and any Credit Reference or Fraud Prevention Agencies as allowed by the Data Protection Acts. e) Please be aware that your credit limit can increase or decrease without referral. f) We reserve the right to decline applications and amend or withdraw credit accounts subject to status and / or company policy. I, a Director / Sole Trader / Partner, agree to guarantee performance of all financial obligations of the company and its subsidiaries to Robert Pochin Ltd. PLEASE RETURN YOUR COMPLETED APPLICATION FORM TO THE BRANCH OF YOUR CHOICE. ALSO SUPPLY A COPY OF YOUR COMPANY LETTERHEAD GIVING REGISTRATION NUMBER AND REGISTERED ADDRESS, IF APPLICABLE.
Print Name: Date: Position in Company: Please note in the case of an incorporated business this form must be signed by a Director
Email Address:
What happens next?
FOR OFFICE USE ONLY
1. You’ll receive an email and a text message letting you know once your account is setup
Limit Set: £
Authorised by:
Account Number:
Date Opened:
2. You’ll receive a separate email requesting you to set your account password for our portal 3. You’ll receive a Welcome Pack with more information about Pochin