Trade Account Application

Company Name & Trading Name (if applicable) *

Company Type *Please select from dropdown menu

Parent Company

Address: Registered Office if a Limited Company

Address Line 1 *

Address Line 2

Country *

City / Town *

Postcode *

Billing Address (if different to Registered Office)

Address Line 1

Address Line 2

Country

City / Town

Postcode

Delivery Address

Address Line 1

Address Line 2

Country

City / Town

Postcode

Phone Number - Office

Website

Company Reg. Number

VAT Number

EORI Number or Tax ID Number

UKIMS Number (Northern Ireland Only)

Preferred currency for invoicing

Please select from dropdown menu

Contact Name

First Name *

Last Name

Phone Number - Mobile

Email Address *

Password *

Trade References: Please supply the names and contact details of other fabric and wallpaper suppliers with which you have existing trade accounts.

1. Company Name, Contact Name, Contact Number *

2. Company Name, Contact Name, Contact Number *

3. Company Name, Contact Name, Contact Number

By submitting this application, I, the undersigned, certify that all the information on this application is accurate and true to the best of my knowledge. In addition, I, the undersigned acknowledge and understand that the preferential terms available to Trade Account Customers is strictly for the intention of the re-sale of Impeco & Impeco products, and that Impeco & Impeco reserves the right to reject this application or to terminate it at any time. Please note that this application does not grant any credit terms. Our company Terms and Conditions can be downloaded from our website. *

Your details will only be used for the purpose of this application and any further discussions relating to working together.

Signed:

+48713904908

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Trade Account Application