Customer Account Form

Who are you applying for? *IndividualBusiness

General Information

First Name*

Last Name*

Address*

Postcode*

Email Address*

Mobile Number*

Terms and Conditions - Individuals

Please tick this box to confirm that you understand Willbox Ltd will send you a secure Yoti link to verify your identity before conducting a consumer credit check.*I understand

Please upload proof of ID (passport/ drivers license) *

Upload File

Max file size 10MB.

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Please upload proof of your address (for example, a utility bill dated within 90 days) *

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Max file size 10MB.

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Primary Contact Information

First Name*

Last Name*

Mobile Number*

Email Address*

Company Details

Company Name *

Registered Address *

Postcode *

Company Number *

Trading Since *

VAT Number

Invoice contact details

Accounts Address *

Accounts Postcode *

Accounts Phone Number *

Accounts Email Address *

Is a PO number required for invoice? *YesNo

Terms and Conditions - Business

Please tick this box to confirm that you agree to Willbox Ltd contacting a company director
where required for a guarantor request. *I understand

Please upload a company letter head*

Upload File

Max file size 10MB.

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Please upload a copy of hired in plant insurance *

Upload File

Max file size 10MB.

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Direct Debit Mandate

Direct debit is mandatory for all new customers

Please confirm you have completed the direct debit link -
https://secure.edirectdebit.co.uk/Willbox-Ltd/payments?locale=en-GB *I confirm

Confirmation

I confirm that this application and signature below confirms that all business between the applicant and Willbox Limited will be carried out in accordance with WILLBOX Ltd standard terms and conditions, including settlement terms and interest charges for late payment.
‍
If I am signing on behalf of a company, my signature confirms authorisation to contact the bank and referees as listed above to substantiate any agreed credit terms, and I confirm that I am authorised to sign this form on behalf of the above Company.

Date

Signed by*

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Clear Signature

Confirm Signature

Position *

I confirm I have read and agree to the following terms and conditions -
https://www.willbox.co.uk/terms-and-conditions *Yes

Thank you! Your submission has been received!

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Something went wrong. Try removing any links from your message as these can trigger our spam filtering. If you are still unable to submit the form, please contact us on 0800 023 5060 or send an email to enquiries@willbox.co.uk with your name, phone number and company name.