Credit Application Form

Step 1: Business Information

Applicant's (Business) Name

Trading Name

Business Type

Name

Home Address

Identity Number

Shareholding/Membership (%)

Email for Signature

Physical Address

Postal Code

Telephone Number

Fax Number

Registered Address

Postal Code

Email Address

VAT Registration Number

Date Business Commenced Trading

Auditor/Accountant Details

Sequestration Details

Bank Name

Branch

Account Name

Account Number

Supplier

Telephone Number

Credit Limit

Credit Limit Required (per month)

Note: Signature links will be sent to owners' email addresses provided in Step 2. You may also provide an additional signature here.

Full Name

Capacity

Signature