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CREDIT APPLICATION

Please read through the WACO MODULAR STANDARD CONDITIONS below before filling in the form.
Sale
Hire

COMPANY DETAILS

Applicant's Email Address

Legal Entity Type

Quotation Number

Order Type

Trading Name

Registered Name

Holding Company Name

Nature of Business

Registration Number

e.g. 2023/123456/07

VAT Number

Accounts Contact Email

Auditors / Accounting Officer

Company Start Date

Present Total Asset Value

Present Annual Turnover

Has the business ever made a compromise with its creditors or been placed under judicial management?

If yes, please provide details

Postal Address

Postal Code

Physical Address

Physical Code

Telephone Number

Fax Number

Site Contact Person

Site Contact Email

Accounts Contact Person

DIRECTORS / PARTNERS / MEMBERS / OWNERS (We require the personal details of ALL directors / partners / owners / members of the legal entity. Should there be more than three, please attach an annexure to this form.)

Director 1 Full Name

Director 2 Full Name

Director 3 Full Name

Director 1 ID Number

Director 2 ID Number

Director 3 ID Number

Director 1 Cell Number

Director 2 Cell Number

Director 3 Cell Number

Director 1 Residential Address

Director 2 Residential Address

Director 3 Residential Address

TRADE REFERENCES

Reference 1 Supplier Name

Reference 2 Supplier Name

Reference 3 Supplier Name

Reference 1 Tel Number

Reference 2 Tel Number

Reference 3 Tel Number

Reference 1 Credit Limit

Reference 2 Credit Limit

Reference 3 Credit Limit

BANK DETAILS

Bank Name

Account Holder Name

Account Number

Branch Name

Branch Code

OTHER DETAILS

Does your company use official purchase orders?

Authorised Purchaser 1

Required

Authorised Purchaser 2

Authorised Purchaser 3

APPLICANT CONFIRMATION

Signatory Name

Designation

Signing Date

Signing Place

DOCUMENT CHECKLIST

Company resolution authorising the signatory to sign the credit application form

Company registration forms i.e. CK1 / CM1 Forms or Certificate of Registration

VAT registration certificate

ID Copies of all directors / partners / members / owners

SARS Tax Clearance Certificate

Cancelled company letterhead with company’s physical address

Proof of banking details (bank stamped letter or cancelled cheque)

Audited annual financial statements

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