Please be patient. Your Application is on it's Way!

Your Application Progress

ROM Credit Application

Thank you for your interest in applying for Credit Facilities with ROM Ltd.

Before starting your application for a credit account with us, please ensure you have the listed documents below. Without these you will not be able to proceed with your application as these are required for our credit checks.

Your Company Letter Head
Two Trade Reference contact details, including contact number and e-mail address
A copy of your VAT Certificate

Please refrain from using the "&" ampersand symbol during the application form as this may cause delays in us receiving your application

Once the application has been completed and the required documents uploaded a £1.00 deposit into our bank account is required to help prevent against fraudulent activity. Bank details are provided at the end of the application.

Please Note: The £1.00 credit balance will be added onto your account once the account has been setup for you to deduct in your first payment to us.

Everything marked as * is a mandatory question

We would recommend opening the application in Google Chrome

Full Trading Title: *

Invoice Address Line 1: *

Invoice Address Line 2: *

Invoice Town: *

Invoice County: *

Invoice Postcode: *

Accounts Payable Telephone No: *

Accounts Payable Email: *

Would you like to receive your Invoices & Statements via PDF: *

Bankers Name: *

Bankers Address Line 2: *

Bankers County:*

Bank Account Number:*

Nature of Business:*

Total Credit Limit Required:* £

Upload your company letterhead document (jpg, png, pdf, docx, tif) 5Mb Max: *

Are you a limited company? *

Yes No

Statement Address Line 1: (if different)

Statement Address Line 2:

Statement Town:

Statement County:

Statement Postcode:

Fax No:

Contact Name: *

Invoices: Statements:

Email Address For Statement: *

Email Address For Invoices: *

Bankers Address Line 1: *

Bankers Town: *

Bankers Postcode: *

Sort Code: *

How long established? *

Invoice Currency: *

Browse

Company Name (if different from above)

Limited Company Address Line 2:

Limited Company County:

Company Registration No: *

VAT Reg No:*

Name of Director 1: *

Name of Director 3:

Upload your VAT Certificate (jpg, png, pdf, docx, tif) 5Mb Max: *

Limited Company Address Line 1: (if different from above)

Limited Company Town:

Limited Company Postcode:

Incorporation Date: *

Name of Ultimate Holding Company (if applicable)

Name of Director 2:

Name of Director 4:

Browse

Please provide two trade references who we may contact for further information regarding your credit application.

Company Name of Reference 1: *

Name: *

E-Mail Address Of Reference Name 1: *

Telephone No Of Reference Name 1 : *

Company Name of Reference 2: *

Name: *

E-Mail Address Of Reference Name 2: *

Telephone No Of Reference Name 2 : *

I/We hereby apply for a credit account and agree to pay accounts by the last day of each month following month of collection or delivery.

I/We hereby agree to operate my/our account in accordance with ROM LTD s Terms and condition of sale which are deemed to have been accepted upon the completion of the account appllication form. Read More T&C

I/We confirm the particulars stated above are correct and I am authorised to act on behalf of the company applying for credit facilities.

I/We authorise ROM Ltd to make status enquiries in connection with this application for credit facilities.

Print Name:*

On behalf of (Business Name) : *

Bank	Wells Fargo Bank NA
Account Name	Rom Limited
Sort Code CHAPS	16-56-71
Sort Code BACS	40-51-33
Account	88006303

GBP Payments
Bank	Wells Fargo Bank NA
Account Name	Romtech Limited
Sort Code CHAPS	16-56-71
Sort Code BACS	40-51-33
Account	88006305

I confirm that I have paid the £1 deposit *

Title/Status: *

Date: *

Euro Payments
Bank	Wells Fargo Bank NA
Account Name	Romtech Limited
IBAN	GB83PNBP16567188006306
SWIFT BIC	PNBPGB2L
Account	88006306

IMPORTANT DATA PROTECTION

We will use the information collected on this form to register your account, for our internal record keeping to assess your credit worthiness, which may involve passing the information to credit reference agencies, and receiving information from them about you. If we do use the information to make a search with a credit reference agency, that agency will keep a record of that search and will share that information with other businesses. We may also make enquiries about the principal directors with the credit reference agency. We will monitor and record information relating to your trade performance and such records will be made available to credit reference agencies, who will share that information with other businesses in assessing applications for credit and fraud prevention.

I consent to the information I have provided for the processing of my Credit Application to be used by ROM for the sole purpose of processing my credit application. I also consent for this information to be retained by ROM while I/my company remain a customer of ROM.

Company Name (if different from Section A)

Proprietor 1

Full Name(s) of Proprietor 1*

Address Line 1 (if different from Section A)

Town (if different from Section A)

County (if different from Section A)

Postcode (if different from Section A)

VAT Reg No: *

Upload your VAT Certificate (jpg, png, pdf, docx, tif) 5Mb Max: *

Proprietor 2

Full Name(s) of Proprietor 2

Browse

Please provide two trade references who we may contact for further information regarding your credit application.

Company Name of Reference 1: *

Name: *

E-Mail Address Of Reference Name 1: *

Telephone No Of Reference Name 1 : *

Company Name of Reference 2: *

Name: *

E-Mail Address Of Reference Name 2: *

Telephone No Of Reference Name 2 : *

I/We hereby apply for a credit account and agree to pay accounts by the last day of each month following month of collection or delivery.

I/We confirm the particulars stated above are correct and I am authorised to act on behalf of the company applying for credit facilities.

I/We authorise ROM Ltd to make status enquiries in connection with this application for credit facilities.

Print Name: *

On behalf of (Business Name) : *

Bank	Wells Fargo Bank NA
Account Name	Rom Limited
Sort Code CHAPS	16-56-71
Sort Code BACS	40-51-33
Account	88006303

I confirm that I have paid the £1 deposit *

GBP Payments
Bank	Wells Fargo Bank NA
Account Name	Romtech Limited
Sort Code CHAPS	16-56-71
Sort Code BACS	40-51-33
Account	88006305

Title/Status: *

Date: *

Euro Payments
Bank	Wells Fargo Bank NA
Account Name	Romtech Limited
IBAN	GB83PNBP16567188006306
SWIFT BIC	PNBPGB2L
Account	88006306

Your Application Progress

ROM Credit Application

IMPORTANT DATA PROTECTION

Proprietor 1

Proprietor 2

IMPORTANT DATA PROTECTION

ROM GROUP

Email:

sales@rom.co.uk

Telephone:

Your Application Progress

ROM Credit Application

** IMPORTANT DATA PROTECTION **

Proprietor 1

Proprietor 2

** IMPORTANT DATA PROTECTION **

Email:

sales@rom.co.uk

Telephone:

IMPORTANT DATA PROTECTION

IMPORTANT DATA PROTECTION