Step 1 of 4 25% If you’d like to open an account with us, please complete and submit this form online. Alternatively, you can download and print the form here to complete later Credit Application Form Your Personal DetailsCompany Name:*Please select*PLCLimitedPartnershipSole TraderLLPEmail - Accounts Department:* Other Email: (if applicable) Company Reg. No.:*Telephone:*Fax:Invoice Address:* Street Address City State Zip/ Postal Code Account InformationBank Name:Bank Address:* Street Address City State Zip/ Postal Code Trade Ref Name:*Account Number:*Sort Code:*Credit Limit Request (£):Trade ref Address:* Street Address City State Zip/ Postal Code Landline:*Fax: Purchase Ledger ContactName:*Landline:*Mobile:Email:* BuyerName:*Landline:*Mobile:Email:* * Peter Hird & Sons Ltd may wish to use this information above to inform you of future promotions. The data will not be shared with any organisation that is not associated with Peter Hird & Sons Ltd. Please tick this box if you do not wish to receive news of future promotions Damage WaiverIf you have your own hired-in plant insurance then please indicate below, please note that if you select this option we require a copy of your hired-in plant insurance policy to be sent with the return of completed form. I have my own Hired-in Plant insurance Proof of Hired-in Plant Insurance* Drop files here or If you do not provide details of your insurance our damage waiver will automatically apply and you will be subject to an damage waiver fee per hire contract. A £1000 excess applies in the event of any claim.DisclaimerThis ofﬁce utilises a third party credit reference agency for credit assessment purposes. In submitting a request for this ofﬁce to open a credit account, you are hereby providing us with your consent to carry out any credit reference searches that we deem necessary to support your application. These searches will be taken for credit information purposes only and may be carried out on both your company and its principals. The credit reference agency may also keep a record of our enquiry, and share that information with other businesses that may also make enquires about the company and its principals. This does not affect your statutory rights. You are also agreeing to abide by the Terms and Conditions of this ofﬁce, in the absence any written authority, strictly from this ofﬁce, to the contrary. Our payment terms are strictly nett monthly.Terms & ConditionsPlease read the Terms & Conditions* By signing this I confirm I that I have read and accept the CPA Model Terms and Conditions of hire (July 2011), Hire insurance / damage waiver conditions as detailed on this account application form Name* Date* Signature*EmailThis field is for validation purposes and should be left unchanged.