Application For Mosella UK Trade Account

Mosella UK Ltd
8 Steel Lane
Catcott Office 01278 722777
Somerset Mobile 07977 210078
TA7 9HP Email mosellasouthwest@yahoo.co.uk

So we can consider your application swiftly please complete this form and hit the submit button. We will respond to your application within 72-hours.

REFERENCES




BANKING DETAILS

10. PROPRIETORS, PARTNERS, DIRECTORS: DETAILS



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STATEMENT OF ACCEPTANCE OF TERMS OF APPLICANT:

I/We apply for credit facilities with Mosella UK Ltd subject to their Standard Terms and Conditions, a copy of which I/We acknowledge receipt and I/We undertake to pay each invoice by the due date.

I/We hereby consent to the processing by Mosella UK Ltd and/or on their behalf by the agents of such data as are contained in the Credit Account Application form and any associated document in accordance with requirements of the Data Protection Act 1968 for the sole purpose of assessing my/our application for credit facilities.

I/We warrant that the above details are correct and may form part of any contract between us.

Sole Traders Must print and sign email the form personally

Signed Position Date / /

Print Name