Customer Account Application

Credit accounts are subject to approval and completion of this form does not guarantee you will be offered an account. In completing this application you are confirming that you have read and agree to abide by the terms and conditions of business which can be read here and authorised to sign contractual documents on behalf of the business.

Any personal information you give to us will be processed in accordance with the UK Data Protection Act 1998. Cardwave Services Ltd will use the information to process your request and to provide any relevant further information you have requested. It will also be used to support Cardwave's marketing and market research activities.

CUSTOMER INFORMATION

Company Name*

Company Type*

Company Reg No*

Date Company Formed*

Registered Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

EC VAT No*

How did your hear about Cardwave Services Ltd?*

CONTACT INFORMATION

Contact Name (Main)*

Position*

Email*

Tel:*

Contact Name (Finance)*

Position*

Email:*

Tel:*

Website Address*

Bank Details

Credit accounts are subject to approval and completion of this form does not guarantee you will be offered an account. Your initial three orders will require payment in advance before a credit account is offered.

Bank Name*

Bank Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Swift*

IBAN*

Sort Code*

Credit Limit Required If applicable*

Account No*

Declaration

Please confirm:*

I have read and agree to abide by the terms and conditions of business.

I/We are aware that 'Title of Goods' only passes upon full payment.

WARRANTY: In consideration of the granting of credit facilities, I/We agree to make settlement of accounts 30 days from date of invoice.

Name*

First Name

Last Name

For and On Behalf of*

Position*

Date*

Signature*

[clear]

Use your mouse or finger to draw your signature above

Cardwave Services Ltd, Unit 6C Hopton Industrial Estate, Devizes, Wiltshire, SN10 2EU, United Kingdom.

Tel: +44 (0)1380 738395 Fax: +44 (0)1380 738399 Email: info@cardwave.com

VAT No: GB 8502281 51 Company Registered No: 5308339

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