Customer Credit Application

Data Communication Solutions

Opening an Account with us…

Do you want to make a purchase from us but haven’t done so before?

To open an a Credit Account with HCom please either download, complete and return THIS FORM or, alternatively, complete and submit the form below.

Business Type*
- Limited Liability
- Sole Proprietor
- Partnership
Business Name*
Name of Registered Company or Trading Name if not Registered
Website Address
Physical Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Postal Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Accounts Payable Contact Name*
First Last
Accounts Payable Phone Number*
Accounts Payable Email*
Director/ Sole Proprietor/ Partner Name*
First Last
Director/ Sole Proprietor/ Partner Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Director/ Sole Proprietor/ Partner Phone Number*
Director/ Sole Proprietor/ Partner Email*
Trade Reference No 1*
Please supply the Business Name, Contact Name, Address, Email and Phone No. of someone you operate a trade account with, excluding electricity or phone company.
Trade Reference No 2*
Please supply the Business Name, Contact Name, Address, Email and Phone No. of someone you operate a trade account with, excluding electricity or phone company.
Consent*
I am authorised to make this request and have read, and accept, the Terms & Conditions of Sale as displayed on this website.
Name of Authorised Person Requesting Credit Account*
First Last
Position Held by Person Requesting Credit Account*
Date*
DD slash MM slash YYYY