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Tel: 0800 074 0009
Fax: 0871 2106 961

38 High Street, Rowhedge, Colchester, Essex, CO5 7ET

Panic Parcels
Book a Collection

Complete the form below and a member of our staff will contact you as soon as possible

Security Note: Please also be assured that your details will remain entirely confidential
All fields marked with a are compulsory and must be completed in order to process your form

Company Name


Applicants Name


Address


Years trading


Bank Address

Credit Required £


Account Number


Sort Code

Contact Number


Email


Please accept this form as my/our application for a credit account.

Estimated monthly purchases of £:


Signed: (Print Name)


Company Position: (Please Select - Director - Partner - Owner)


I/we give my/our consent to a credit search being made on me/us as owner/partner or director of this organization both now & at any future date.

I/we understand this search will recorded by the agency & may be disclosed to subsequent enquirers.


By submiting this form, I agree that I have read and agree to comply with the Terms and Conditions