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Business Details
Company Name
*
Trading Name
*
Company Reg Number
*
VAT Number
EORI Number
Limited or Sole Trader
*
--- Limited or Sole Trader ---
Limited
Sole Trader
Trading Address
Street
*
Town
*
County
*
Eircode
*
Billing address is different from Trading address
Billing address is different from Trading address
Billing Address
Street
Town
County
Eircode
Email Address
*
Phone Number
*
Contact Details
Name
*
Position
Email Address Contact
*
Phone Number
*
Same as Trading Details
Use the same phone and email as Trading Details
Account Details
Accounts Telephone Number
*
Email address for invoices/statements
*
Email address for bookings
*
Bank Details
Bank
*
Branch
*
IBAN No
*
BIC
*
Estimated Activity
Number of loads per week
*
Driver accompanied
--- Select Choice ---
1
2
Unaccompanied
Credit facility required - €
*
Trade References
Company Name
Contact Name
Phone Number
Company Name 2
Contact Name 2
Phone Number 2
Company Name 3
Contact Name 3
Phone Number 3
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