Customer Credit Application

Please note: Submission of this form does not automatically guarantee customer credit. You will be contacted by Fairfax Plant Hire to confirm your application.

Small Plant

Tool Hire

Access Hire

Tool Shop

Large Plant

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DATE:
CUSTOMER NAME: *
EMAIL ADDRESS: *
BUSINESS TRADING NAME:
REGISTERED ADDRESS:
POSTCODE:
COMPANY REG:
VAT NUMBER:
TELEPHONE: *
FAX:
MOBILE:
BANK NAME:
BANK ADDRESS:
BANK ADDRESS:
ACCOUNT NUMBER:
SORT CODE:
TRADE REF. 1:
TRADE REF. 1 TELEPHONE:
TRADE REF. 2:
TRADE REF. 2 TELEPHONE:
DO YOU HAVE HIRED PLANT INSURANCE?:	YES NO
Comments:
CUSTOMER SIGNED: *
POSITION IN COMPANY:
Please enter the following text: * (human verification)
	*Your details will be transmitted to our customer services team to deal with your query.