Credit Limit Application Form

CORPORATE CREDIT LIMIT APPLICATION FORM

1. Name of Company:  _________
2. Location of work    : _________
3. Mailing Address     : _________

4. Telephone No. (s)   : _________     Fax No. _________
5. Company E-Mail    : _________
6. Nature of Business: ____________________________________
7. Owner/Partner/Directors Name (s) /Nationality (ies)

Name	Nationality	Position

8. Trade License No / Validity: _________
9. Date of Establishment         :  _________
10. Is the Company Dealing with _______________ Yes /No
11. Estimated Monthly Purchases from _______________
12. Total Credit Limit Required _________
13. Bankers Name, Address & A/C Nos:
             a) _________
             b) _________
14. Business References: (please provide details of three companies in ___________ who are extending credit facilities to your company with contact names and telephone numbers)

Company Name	Contact Person	Telephone No	Mobile No.

15. Person (s) Authorized to Sign the Purchase Order: _________
     

Name	Designation	Specimen Signature	Telephone No.

   
16. Person (s) to be contacted for payment: _________

Name	Designation	Telephone No	Mobile No.

I/We undertake to make the settlement of outstanding amount within the period granted to me / us and undertake to pay interest @ __ % p.a. for delayed payment.

I /We agree that _______________ further has the right to take suitable action in case of delay /default in payment.
I/We also confirm an unconditional acceptance of _______________ terms & conditions of sale and will adhere to that unless agreed otherwise in writing.


Authorized Signature(s)                                         Company Name & Stamp

Note:  Please enclose copies of the following document: Valid Trade License / Labour Court Registration/ Chamber of Commerce Registration / Power of Attorney Authorization / ID Card.
This Agreement shall be governed by and construed in accordance with the Laws of the _______________ and the Parties hereto submit to the exclusive jurisdiction of the Courts of the _______________.  In case any dispute arises, it should be settled amicably between the parties within a period of __ month(s); otherwise the jurisdiction of the _______________ shall be applicable.

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