Customer Information Form

If you have any queries or require any assistance with completing this form please telephone head office: +44 (0) 1763 260 666

Company Name

Address Line 1

Address Line 2

Town/City

Postcode

Telephone

Website

Years Established

Registered Office - If different from above

Registered Office Address Line 1

Registered Office Address Line 2

Registered Office Town/City

Registered Office Postcode

Registration No

VAT No

Accounts Email Contact

Buyer Email Contact

Request A Trade Account?

Yes No

If yes, please enter your trade references below. Otherwise, continue to Submit.

Name & Address Of Bankers

Account No

Sort Code

Trade Reference 1 Company Name

Trade Reference 1 Phone Number

Trade Reference 1 Fax

Trade Reference 1 Address Line 1

Trade Reference 1 Address Line 2

Trade Reference 1 Town/City

Trade Reference 1 Post Code

If the company is not a limited company, please complete the section below:

Trade Reference 1 Partner First Name

Trade Reference 1 Partner Surname

Trade Reference 1 Home Address Line 1

Trade Reference 1 Home Address Line 2

Trade Reference 1 Home Town/City

Trade Reference 1 Home Post Code

Trade Reference 2 Company Name

Trade Reference 2 Phone Number

Trade Reference 2 Fax

Trade Reference 2 Address Line 1

Trade Reference 2 Address Line 2

Trade Reference 2 Town/City

Trade Reference 2 Post Code

If yes, please enter your trade references below. Otherwise, continue to Submit.

Trade Reference 2 Partner First Name

Trade Reference 2 Partner Surname

Trade Reference 2 Home Address Line 1

Trade Reference 2 Home Address Line 2

Trade Reference 2 Home Town/City

Trade Reference 2 Home Post Code

Terms & Conditions

I have read and accept the terms and conditions by Tryka LED Ltd

Position