Credit Application

Thank you for choosing us as your trusted supplier. Please complete all required fields and upload the necessary documents so we can process your application quickly. Our team will review your submission and be in touch. If you need any assistance, we’re here to help.

URL

This field is for validation purposes and should be left unchanged.

Full Name of Applicant(Required)

Trading Name of Applicant(Required)

Registration / Identity No.(Required)

Year Commenced Trading(Required)

VAT Registration No.(Required)

Type of Business(Required)

Company

Close Corporation

Partnership

Trust

Sole Proprietor

Other

Annual Turnover(Required)

Over R2 million

Under R2 million

Physical Address(Required)

Postal Address(Required)

CONTACT DETAILS

Contact Person - Accounts(Required)

Email - Accounts(Required)

Telephone - Accounts(Required)

Cellphone - Accounts(Required)

Contact Person - Buyer

Email - Buyer

Telephone - Buyer

Cellphone - Buyer

Name of Auditors/Accountants(Required)

Physical Address of Auditors/Accountants(Required)

OWNERS, MEMBERS, PARTNERS, DIRECTORS

FIRST DIRECTOR / MEMBER / PARTNER / PROPRIETOR

Full Name(Required)

Residential Address(Required)

SECOND DIRECTOR / MEMBER / PARTNER / PROPRIETOR

Full Name

Residential Address

THIRD DIRECTOR / MEMBER / PARTNER / PROPRIETOR

Full Name

Residential Address

BUSINESS TRADE REFERENCES

Please provide a list of THREE major creditors (non-affiliated companies only)

Business Name

Contact No.

Contact Person

Business Name

Contact No.

Contact Person

Business Name

Contact No.

Contact Person

CREDIT REQUIRED

Credit Required

Terms

BANK DETAILS

Account Holder(Required)

Name of Bank and Branch(Required)

Account Number(Required)

SWIFT Code(Required)

ADDITIONAL DOCUMENTS REQUIRED

Resolution

Max. file size: 4 MB.

Resolution of the Applicant applying for credit and giving authorisation to individual signing the application form on behalf of the Applicant

Certified copy of Signatory's ID/Passport

Max. file size: 4 MB.

Information required in terms of the Financial Intelligence Centre Act, No. 30 of 2001

Form CM1 or CM3) or CoR14.1 (Certificate of Incorporation)(Required)

Max. file size: 4 MB.

Form CM46 (Certificate to Commence Business)(Required)

Max. file size: 4 MB.

Form CM29 (SA Companies) or CoR 39 and other company registration documents (Other Companies)(Required)

Max. file size: 4 MB.

Form CK1 and (if applicable) Form CK2 and CK2A(Required)

Max. file size: 4 MB.

Trust Deed(Required)

Max. file size: 4 MB.

Letters of Authority(Required)

Max. file size: 4 MB.

Identity document/s(Required)

Max. file size: 4 MB.

Proof of Address/es (not older than 3 months)(Required)

Max. file size: 4 MB.

DECLARATION

I/We agree that the information supplied herein is true and correct and I/we undertake to notify Lining & Textile Distributors Proprietary Limited immediately in writing of any changes to the details furnished herein.

I/We agree that:

by my/our signature hereto, we agree and undertake to be bound by the terms and conditions and headed "Terms and Conditions"; and
all credit and goods are supplied subject to the Terms and Conditions; and
I/We, the undersigned, am/are duly authorised to represent the Applicant and to bind the customer to this Agreement.

Name(Required)

Capacity(Required)

Signature

Credit Application

CONTACT DETAILS

OWNERS, MEMBERS, PARTNERS, DIRECTORS

FIRST DIRECTOR / MEMBER / PARTNER / PROPRIETOR

SECOND DIRECTOR / MEMBER / PARTNER / PROPRIETOR

THIRD DIRECTOR / MEMBER / PARTNER / PROPRIETOR

BUSINESS TRADE REFERENCES

CREDIT REQUIRED

BANK DETAILS

ADDITIONAL DOCUMENTS REQUIRED

DECLARATION

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