Apply for an Aktiv dealer account

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1 Step 1

Applicant Business Name

Address

Contact Name

Position

Tel

Fax

Mob

Invoice Address(if different)

Tel

Fax

Nature of Business

Number of years trading in current style

Company Registration Number

Company type

Sole TraderLimited CompanyPLCPartnership

VAT Registration No

Bankers Name and address

Bankers Sort Code

Account Number

IBAN (if used)

Alternative Contacts/Sites

Name and address

Contact Telephone

Anticipated amount of credit required

Any Special Instructions

Application completed by (PRINT NAME)

Date

Signatureupload

Upload

Position

Opening Account Pricing

Comment

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