T: 020 7351 4440  E: info@jasondsouza.co.uk  W: www.jasondsouza.co.uk

Company Information

Type of Business (please tick appropriate boxes)

Please Tick The Companies Listed Below With Whom You Have Account Facilities

If none of the above, then please state another two:

ACCOUNTS MAY BE REFUSED OR CLOSED AT OUR DISCRETION & COMPLETING THIS FORM DOES NOT ENTITLE YOU TO A CREDIT FACILITY. PLEASE RETURN A SIGNED COPY OF THIS FORM TO OUR OFFICE FOR PROCESSING. YOU WILL RECEIVE A COPY OF YOUR APPLICATION VIA EMAIL. PLEASE RETAIN YOUR COPY FOR YOUR RECORDS.

DECLARATION: I/WE ACKNOWLEDGE THAT TRADE ACCOUNTS ARE ONLY OPENED IN RESPECT OF SELECTED RETAIL OUTLETS AND BONA FIDE INTERIOR DESIGNERS, SUBJECT TO JASON D'SOUZA LTD STANDARD TERMS & CONDITIONS ATTACHED AND WHICH I/WE ACKNOWLEDGE RECEIPT

CLICK HERE TO VIEW OUR TERMS & CONDITIONS

24/11/2017

*indicates a mandatory field