ACCOUNT APPLICATION FORM

Proprietors Name:

Company Name:

Company Registration No (if Ltd):

ADDRESS:  (Note - If using P.O. Box No. for business address, please give Proprietors/Directors home address  as well).

Post Code                            Tel No:                      Fax No:                     Mobile:

V.A.T. Reg. No

Photo ID provided:

TRADE REFERENCE 1 (please include address and telephone number for these)

TRADE REFERENCE 2

Would you please complete and sign the Status Enquiry Form as required by all banks for us to obtain a bank reference.

BANKERS                  

SORT CODE

ACCOUNT NO                                               ACCOUNT NAME

SIGNED.................................

Post to: 41-42 Frederick Street                Fax to:  0121 212 454

            Hockley

            Birmingham

            B1 3HN

www.lois-jewellery.com