CREDIT APPLICATION FORM TEMPLATE(1)

COMPANY NAME COMPANY TYPE TRADE LICENSE NO. VAT REGISTRATION NO.

TEL NO. FAX NO. EMAIL REGISTERED ADDRESS

CREDIT APPLICATION FORM

BUSINESS INFORMATION

NAME TITLE PASSPORT NO. MOBILE NO.

DETAILS OF OWNERS/PARTNERS NAME TITLE PASSPORT NO. MOBILE NO.

NAME TITLE MOBILE NO. EMAIL

BUSINESS CONTACT INFORMATION NAME TITLE MOBILE NO. EMAIL

BANK NAME ACCOUNT NO. BRANCH LOCATION RELATIONSHIP MGR.

BANK / CREDIT INFORMATION BANK NAME ACCOUNT NO. BRANCH LOCATION RELATIONSHIP MGR.

REFERENCE 1

BUSINESS / TRADE REFERENCES

REFERENCE 2

COMPANY NAME ADDRESS CONTACT PERSON TEL NO. MOBILE NO. CREDIT LIMIT PAYMENT TERMS

REFERENCE 3

COMPANY NAME ADDRESS CONTACT PERSON TEL NO. MOBILE NO. CREDIT LIMIT PAYMENT TERMS

REFERENCE 4

COMPANY NAME ADDRESS CONTACT PERSON TEL NO. MOBILE NO. CREDIT LIMIT PAYMENT TERMS

COMPANY NAME ADDRESS CONTACT PERSON TEL NO. MOBILE NO. CREDIT LIMIT PAYMENT TERMS

NAME TITLE

SIGNATURE

AUTHORISED SIGNATORIES ON LPO NAME TITLE

SIGNATURE

NAME TITLE SIGNLY/JOINTLY

SIGNATURE

AUTHORISED SIGNATORIES ON CHEQUES NAME TITLE SIGNLY/JOINTLY

SIGNATURE

DHS. DAYS FROM INVOICE DATE

CREDIT LIMIT

? TRADE LICENSE ? MEMORANDUM OF ASSOCIATION ? POWER OF ATTORNEY ? VAT REGISTRATION CERTIFICATE

DOCUMENTS REQUIRED ? BANK STATEMENT (LAST 3 MONTHS) ? PASSPORT COPIES OF ALL PARTNERS ? EMIRATES ID COPIES OF ALL PARTNERS

CUSTOMER DECLATRATION

1. We would like to apply for credit facility to cover our monthly purchases from you for amount : ____________________________

2. We agree to settle all payments on due date as per invoice.

3. We hereby agree, that all information provided above is correct

m : ,

____________________________ OES< m

.

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4. By submitting this application, you authorize DAYAL BUILDING MATERIALS TRADING LLC to make inquiries into the banking and business/trade references that you have supplied.

DAYAL >s ?

OES <

BUILDING MATERIALS .< , ?S , /

TRADING LLC ?

AUTHORISED SIGNATORY

FOR DAYAL BUILDING MATERIALS TRADING ONLY

APPROVED AMOUNT SALES MANAGER

COMMERCIAL MANAGER MANAGING DIRECTOR

MANAGEMENT APPROVAL CREDIT TERMS

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