Full Trading Name Full Trading Address Town Postcode Telephone Number Fax Number Email Address Website Name Address Postcode Contact Number Date Incorporated Number of Employees VAT Number Company Number Sales Rep Current Turnover Type of Business (please select from below) Service and repairDistributionRetail / B2BWholesaleOnline Social Media PlatformFacebook Social Media ID Twitter Instagram Linkedin Google+ Purchaser Name Purchaser Contact Number Purchaser Mobile Number Purchaser Email Address Accountant Name Accountant Contact Number Accountant Mobile Number Accountant Email Address Please provide two references Reference One Name Address Contact Number Email Address Reference Two Name Address Contact Number Email Address Please attach your company registration certificate, VAT certificate and company letterhead. PDF | JPG format only, 5MB file size limit: Declaration by applicant: I/We understand that the information above will be used by Genuine Solutions for evaluation purposes and that all the details provided are accurate. I/We also understand that all information supplied will be treated as confidential. I/We hereby agree that all transactions are conducted in accordance with the terms and conditions of Genuine Solutions. Sign Date I have read and agree to the terms set out in the Genuine Solutions Ltd terms and conditions.