Becsco Limited Credit Reference Form

We have been given your name as a supplier reference by the following company.

Could you please complete the form below to enable us to move forward with the credit application.

Company/Trading Name(Required)

Registered Office Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Are the deatils above correct(Required)

Yes

How long have you traded with them(Required)

What is the maximum credit allowed(Required)

What are their payment terms(Required)

Are payments normally(Required)

Prompt

Slow

Very Slow

Have you ever had cause to withhold supplies(Required)

Have your bankers had to represent a cheque(Required)

Are you associated or connected with this company in anyway?(Required)

Any other comments

In signing this we declare that the information given in this form is to the best of our knowledge and belief correct.

We further declare that this company is not a subsidiary or associated company of ours and that we have no interest, either directly or indirectly.

Your company(Required)

Name of Signatory(Required)

First Last

Position of signatory(Required)

Your Signature(Required)

Send a copy of the data entered on this form to

Enter the email address that you would like a copy of form entry sent to

Enter Email Confirm the address

CAPTCHA