Carrick Depot
028 9336 1666
Mallusk Depot
028 9083 7766
Carrick Depot
028 9336 1666
Mallusk Depot
028 9083 7766
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Company Details
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Company Name: *
Address: *
Telephone Number:
Mobile Number: *
Email Address: *
VAT No: *
Registration No: *
Date Started Trading *:
Date Company Registered *:
Delivery Address:
If different from above
Contact Name: *
Telephone Number: *
Email:
Business Activity: *
Please specify
Breakdown Service: *
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Number Of Vehicles: *
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Billing Detials
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Bank Details
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References
I/We authorise you to take up references at any time from the trade sources listed below.
We will make searches with a credit reference agency, which will keep a record of those searches.
We will not share information with other businesses unless you request us to do so.
Signature: *
Reference 1
Company Name: *
Address:
Contact No: *
Email: *
Reference 2
Company Name:
Address:
Contact No:
Email:
I/We have read, understood and retained a copy of your
Terms and Conditions
(including full retention of title clause).
I/We agree to trade in accordance with these for any goods supplied. I/We confirm the above details are correct.
Signature (Director/authorised Signature)
Name: *
Signature: *
Signature Date *:
Return Form:
Please upload a copy of the letterhead or company stamp showing full legal company name
Select file
Contact Info
Email:
alice@magowantyres.co.uk
Address:
62 Mallusk Road, Newtownabbey
Phone:
028 9083 7766
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