COMPANY DETAILS Full Registered Name: Trading Name: Date of Incorporation: Registration Number: Vat Number: Vat 13B Registeration Number: Trading / Billing Address: Registered Company Address: CONTACT DETAILS Telephone Main: Email Main: Fax Main: Telephone Accounting: Email Accounting: Fax Accounting: Managing Director: Email : Finance Manager: Email : Traffic/Shipping Manager: Email : ACCOUNT REQUIREMENTS Estimated Credit Required per Month : € COMPANY BANK DETAILS Bank Name: Address: Account Number: Sort Code: TRADE REFERENCES FREIGHT / TRANSPORT COMPANIES PREFERABLY Supplier Name: Address: How long? Phone: Email : Fax: Contact: Position: Supplier Name: Address: How long? Phone: Email : Fax: Contact: Position: IMPORTANT INFORMATION CREDIT TERMS: • All invoices become due 30 days from date of invoice excluding Vat & Duties which are subject to immediate settlement • All business transacted is subject to the term of our Standard Trading Conditions available on our website www.emerald-freight.com Signed: Date: • Payment of account may not be held against insurance claims: • We do not insure your goods however we can arrange Cargo Insurance cover upon request and subject to payment of the appropriate insurance premium. • If your account exceeds the agreed credit limit a payment on account will be required to bring your account into line • Failure to comply with the agreed terms may result in your credit terms being revoked CONTACT INFOMRATION FOR SENDING INVOICES & STATEMENTS Invoices: Email : Statements: Email : Special Billing Instructions: DECRALATION I hereby acknowledge the above, which I have read, understood and accept: Authorized Signature: Date: Print Name: Postion : By using this Website you agree with the storage and handling of your data by this website.