Fortress Technology (Europe) Ltd
The Phantom Building
7 Beaumont Road
Banbury, UK
OX16 1RH
CUSTOMER ACCOUNT APPLICATION FORM
SECTION 1: YOUR COMPANY INFORMATION
Please fill in your contact information below:
Company Registration No.
Full Name of Company
43730586
SQUADRA, Limited Liability Company
Business Address (if different)
Registered Address
01011, Kyiv, Rybalska street, building 13, office 4. Ukraine
SECTION 2: STATUS
(Please tick one box only)
Limited Company Partnership Sole Trader Other (please specify)
SECTION 3: SOLE TRADERS AND PARTNERSHIPS
Please provide the full name, home address and telephone number of the Principal (where sole trader) and every partner in the firm.
Name
Name
Spytskyi Oleh
Telephone no.
Telephone no.
+38(073)56-777-65
Name
Home address
Darya Kryzhanovska
Telephone no.
+38(095)439-18-53
Home address
Home address
www.fortresstechnology.co.uk
Registered Office “Old Bartons”, High St, Shutford, Oxon, OX16 6PQ Registered in England & Wales No. 3811425 T: +44 (0)1295 256266 F: +44 (0)1295 255987
SECTION 4: BUSINESS DETAILS
SECTION 5: TRADE REFERENCE INFORMATION
Invoice Address (if different from 1 above) VAT No
Squadra LLC 437305826553
Rybalska Street
01011 KIEV Telephone
UKRAINE
+38073 56 777 65
Fax
Accounts Contact Name
Oleh Spytskyi
Email
Anticipated Credit Limited Required
[email protected]
£
Please list information for TWO companies that you authorise us to contact for a Trade Reference.
(Note: these should be suppliers who extend credit to your company)
Name of Company Name of Company
Contact Name Contact Name
Telephone Telephone
Fax Fax
Address
Address
Email
Email
Simple Operation Outstanding Reliability Exceptional Performance
SECTION 6: OTHER INFORMATION
Any other relevant facts which may affect your credit worthiness
CTION 7: CONSENT
This consent form hereby authorises the companies named in Section 5 to supply Fortress Technology (Europe) Limited
with information regarding their opinion on the credit worthiness of our business. This information is essential to the
extension of credit to our business. We understand that any information provided will be used solely to evaluate our
credit worthiness.
Signature of applicant Fortress Technology (Europe) Ltd
The Phantom Building
7 Beaumont Road
Name (in block capitals) Banbury, Oxon
OX16 1RH
OLEH SPYTSKYI
@fortresstechnology.com
T: 01295 256266
F: 01295 255987
SECTION 4: RETURN INFORMATION
Position in company/firm
Date: Director
For the attention of: Date
Simple Operation Outstanding Reliability Exceptional Performance