TEMPORARY ACCOUNT    APPLICATION FORM
	[MAIN PAGE]    [ACCOUNTS]  [CONTACT US]	Print out a copy of this form
		Fill and return to  Mckennas              1, 3, +5 Market St. Listowel

Phone 068-21044    Fax 068-21179    Email enquiries@mckennas.ie   Website www.mckennas.ie

Surname:	First name(s)
Address	Phone   Home:   Work:   Mobile:
	Email address:
Reason for account
Person to arrange payment	Account valid until
Person(s) authorised to sign for goods
Order number required	One invoice per despatch

Trade References
Name Address Phone	Name Address Phone

Bank Details
Name	Address	Account number
I understand and agree to the conditions attached to the account. I understand that your credit terms are that the payment is due promptly within 30 days following the month of invoice, and that goods may be refused if this condition has not been fulfilled. I understand that credit terms may be withdrawn at ant time and without prior notice. A credit charge of 2% per month will apply to overdue accounts. Legal title and ownership of goods shall remain with J. McKenna Ltd. until payment has been made in full in respect of any nature outstanding. Signed:                             Date:                  Credit limit: €                     Deposit:€

Guarantors of account (where account is administered by a comittee)

Account name_____________________  Number________________ I/We agree to act as guarantors and understand that I/we are liable to pay any outstanding debts, including all finance charges, on behalf of the account holder. Signed_______________________________         Date__________ Signed_______________________________         Date__________ Signed_______________________________         Date__________

~ For office use ~
Account number PC:	Type of business SD:
Approved by Approved by Approved by	Date Date Date
Set up by	Date