Apply For A CEMEX Credit Account

Business Details

Business Name *

Trading Name (If Different)

Business Type *

Company Reg Number (If Ltd)

Business Trading Address

Address Line 1

City / Town

County

Post Code

Landline Phone Number *

Mobile Phone Number

Proof Of Address *

Please only upload the following formats: PDF, DOCX, DOC, JPG

Accounts Payable

Contact Name

Position

Contact Details

Telephone

Mobile (For SMS)

Email Address *

Bank Details

Bank Name

Name Of Account Holder

Sort Code

Account Number

Preferred Payment Method

Personal Details

Sole Trader / Partner / Director Name *

Date Of Birth

Telephone / Mobile Number

Home Address

Post Code

Time At Address

Occupancy Status

Previous Address In Last 3 Years

Position

Date Information Submitted

Decleration

By Submitting This Form
I/We hereby request you to open a credit account and have read your terms of payment and accept these as the basis of trading. I/We have also read your standard conditions of sale (available at www.cemex.co.uk/termsandconditions) and agree that all transactions shall be subject to these. I understand that the information provided in this account opening application may be (1) disclosed to licensed credit reference agencies and a credit circle consortium, who may retain a record of search (2) used by members of a credit circle in assessing any application from you and for occasional debtor and fraud protection and I/We agree to the use of this information for these purposes. I/We also understand that information relating to our trade performance will be made available to credit reference agencies and credit circle members who will share that information with other businesses to assess applications for credit and I/We also agree to the use of this information for these purposes. All information will be held and otherwise used by CEMEX in accordance with the terms of our Privacy Policy available at cemex.co.uk. I/We confirm that the details contained in this form are accurate and complete and, on behalf of the prospective customer, have appropriate authority to open an account and enter into legal agreements with CEMEX.

Data Processing
By submitting your details above, you consent to us processing your personal data in accordance with the CEMEX UK Privacy Policy which you confirm that you have read and understood

Process Data *

Apply For A Credit Account