Vigor Cement (Pty) Ltd

Credit Application Form

Reg: 2019/121626/07 | VAT: 4870296698

57 Kasteel Road, Suite 115 Domus Building, Lynwood Glen, Pretoria

A. Applicant Company Details

Full Registered Company Name *

Registration Number *

VAT Number *

Trading Name (if different)

Physical Address of Head Office *

Postal Address (if different)

Telephone Number *

Email Address *

Website

Date Established *

Type of Business *

Nature of Business/Industry *

Primary Contact Person for Accounts/Credit

Name and Surname *

Designation *

Contact Number *

Email Address *

B. Requested Credit and Banking Details

Desired Credit Limit (ZAR) *

R

Current Bank *

Branch Name and Code *

Account Name *

Account Number *

C. Trade References

Provide details of at least three suppliers with whom you currently hold credit accounts.

Reference 1

Supplier Name *

Contact Name *

Telephone *

Email *

Credit Terms *

Reference 2

Supplier Name *

Contact Name *

Telephone *

Email *

Credit Terms *

Reference 3

Supplier Name *

Contact Name *

Telephone *

Email *

Credit Terms *

D. Directors/Members Details

Provide details of all directors/members as per Company Registration.

Director/Member 1

Full Name *

ID Number *

Designation *

Contact Number *

Residential Address *

Director/Member 2

Full Name *

ID Number *

Designation *

Contact Number *

Residential Address *

E. Surety / Personal Guarantee

        Important: To be completed by a Director/Member. This section is vital for securing the debt.
      

I, the undersigned, in my capacity as Director/Member of the Applicant Company and being duly authorized, do hereby unconditionally and irrevocably bind myself as surety and co-principal debtor in solidum with the Applicant to Vigor Cement (Pty) Ltd for the due and punctual payment of all amounts which are now or may at any time hereafter be owing by the Applicant to Vigor Cement (Pty) Ltd, from whatever cause arising.

Guarantor Full Name *

Guarantor ID Number *

Date *

F. Declaration and Authorization

Payment Terms: Payment is due 30 days from invoice/statement.

Credit Limit: Vigor Cement reserves the right to adjust or withdraw the credit facility.

Interest: 2% per month on overdue amounts.

Collection Costs: Applicant liable for attorney-client scale costs.

Risk: Passes on delivery; ownership retained until paid.

Info Disclosure: Applicant authorizes credit bureau checks and data sharing.

        I/We declare that the information provided is true and correct and agree to be bound by the Terms and Conditions.
      

Full Name *

Designation *

Date *

I confirm that I have read and agree to the Terms and Conditions *