Application for a Credit Account

Please fill in ALL fields, then click 'Send Form'.
(Fields marked * are optional)

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Note: This form is not sent over a secure connection.  If you don't wish to send your details this way, please download the form in Word format, complete it and fax it to us at: 01323 639444.
[ Click here to download this form ]


Full name:

Position within company:

Trading address:


Post Code:

Telephone number:


Fax number:


E-mail address:

Home address:
(partnerships and sole traders only)



Post Code:


Date of formation:


Estimated monthly credit required:

  (£ Pounds Sterling)


Trade references:


Reference 1  
(Include Post Code)

Reference 2  
(Include Post Code)

Bankers name and address:


Post Code:

Bank account number:


Bank sort code:


By ticking this box, you agree to be bound by Elliot's standard terms and conditions:

Elliot Office Supplies
41 South Street
East Sussex
BN21 4UP