Customer Partner

Company Name

Company Reg Number

Trading Address

Do you have a different Registered Address? Do you have a different Registered Address? Yes No

Registered Address

Company UTR Number

Date of Incorporation

Primary Contact Person

Primary Contact Telephone

Contact Email Address

Main Office Telephone

Main Office Email Address

Website Address

Accounts Contact Name

Accounts Contact Telephone

Accounts Email Address

Requested Credit Limit (Per month)

Do you use PO numbers? Do you use PO numbers? Yes No

Bank Name

Bank Address

Bank Sort Code

Bank Account Number

Do you hold Hired in Plant Insurance? Do you hold Hired in Plant Insurance? Yes No

Hire in Plant Insurance Provider

Policy Number

Policy Expiry Date

Value of Cover

Company Letterhead Company Letterhead File InputChoose file hereNo Files ChosenAccepted file types: jpg, jpeg, jpe, png, pdf, doc, pages. Max. file size: 1 MB

Company Utility Bill Company Utility Bill File InputChoose file hereNo Files ChosenAccepted file types: jpg, jpeg, jpe, png, pdf, doc, pages. Max. file size: 1 MB

ID of applicant signing below ID of applicant signing below File InputChoose file hereNo Files ChosenAccepted file types: jpg, jpeg, jpe, png, pdf, doc, pages. Max. file size: 1 MB

Insurance Policy Schedule Insurance Policy Schedule File InputChoose file hereNo Files ChosenAccepted file types: jpg, jpeg, jpe, png, pdf, doc, pages. Max. file size: 1 MB

Company Name

Contact Name

Years Traded

Contact Number

Trading Address

Company Name

Contact Name

Years Traded

Contact Number

Trading Address

Declaration Declaration I hereby authorise The Hire Partner Ltd to obtain references from the above, as and when appropriate. I agree to abide by the Terms and Conditions as set out by The Hire Partner Ltd which include that all invoices are due to be paid within 30 days from the date of invoice, and that a Purchase Order must be given for services rendered.

Full Name

Date