Main Account Contact

    * Indicates required field

    First Name*

    Last Name*

    Company Position*

    Telephone Number*

    Mobile Number (Optional)

    Email Address*

    Business Details

    Business Name*

    PO Numbers Required*

    Trading Address*

    Address 2 (Optional)

    Town/City*

    Postcode*

    Business Type*

    VAT Number (Optional)

    Trade References (Please Provide Two)*

    Credit Information

    The information entered here will be transferred over a secure network so your details are protected

    Principal Directors*

    Bank Name*

    Bank Address*

    Account Number*

    Sort Code*

    Payment Method*

    Insurance Requirements

    Please provide a copy of your company ‘hired in’ (contractors all risks) insurance. If a copy of your insurance is not provided you will automatically be put on the Lincs Safe Damage/loss waiver scheme of 15% of the hire costs. If insurance document is sent after the contract has begun this cannot be credited and cover will commence from the next hire

    Disclaimer

    Our company carries out credit checks with credit agencies. In submitting an application for a credit account you are hereby giving consent for us to carry out these credit reference searches. These searches are for credit information purposes only and will not be shared with a third party . The data protection act 1998 will be complied with at all times.
    In signing this form you are also agreeing to abide by the terms and conditions of this office and the CPA Model terms and conditions of hire (copy available on request) Payment terms are strictly 30 days from date of invoice unless otherwise agreed in writing.

    I confirm that I wish to open an account with Lincs Hire & Sales Ltd

    Signed By (full name and date)