Credit Account Application & Deed of Suretyship

Complete this form to apply for a credit account with Citilec. All fields marked with * are required. A credit check will be conducted on submission.

Important: Submitting this online form is the first step only. You must also deliver a signed original along with: certified copies of CoR documents, VAT certificate, ID documents and proof of residential address for all directors/members/partners, 3 months' bank statements, and latest financial statements.

CREDIT ACCOUNT APPLICATION

Citilec (Pty) Ltd · Reg. 2005/022163/07 · Tel: 011 334 2737 · Including Deed of Suretyship

Business Details

Registered Name of Business *

Trading Name of Business

Previous Trading / Registered Names

VAT Registration Number

Registration Number of Incorporation

Type of Business Entity

Years Trading

Registered Name of Holding Company

Names of Subsidiary & Associate Companies

Nature of Business Activities

Addresses

Physical Address *

Postal Address

Postal Code

Registered Address

Registered Address Code

Contact & Premises

Telephone (Area Code & No.) *

Fax (Area Code & No.)

Email Address for Creditors Dept *

Premises

Landlord Name & Tel Number

Address of Landlord

Landlord Contact Person

Details of Proprietors / Directors / Members / Partners

Complete details for all directors, members, or partners. At least one entry is required.

Full Name *

ID Number

Cellphone Number

% of Shareholding / Interest

Residential Address

Full Name

ID Number

Cellphone Number

% of Shareholding / Interest

Residential Address

Full Name

ID Number

Cellphone Number

% of Shareholding / Interest

Residential Address

Full Name

ID Number

Cellphone Number

% of Shareholding / Interest

Residential Address

Trade References

Please provide at least two trade references — suppliers who can confirm your credit history.

Company / Supplier Name *

Telephone Number

Address

Credit Limit (R)

Company / Supplier Name *

Telephone Number

Address

Credit Limit (R)

Company / Supplier Name

Telephone Number

Address

Credit Limit (R)

Company / Supplier Name

Telephone Number

Address

Credit Limit (R)

Financial Summary

Annual Turnover (R)

Net Asset Value (NAV) (R)

Year of Financial Statements

Credit Limit Requested (R) *

Estimated Monthly Purchases (R)

Financial & Auditor Details

How Long Has the Proprietor(s) Owned the Business?

Auditors / Financial Officer's Name

Auditor Tel (Area Code & No.)

Banker's Details

Bank Institution

Branch

Account Name

Account Number

Date Opened

Standard Conditions of Sale

INTERPRETATION – Clause headings are for convenience only. "Invoice" means the invoice for goods supplied by Citilec. "Debtor" means any person indicated on the invoice. "Goods" means all items specified on the invoice. "The parties" means Citilec (Pty) Ltd and the Debtor.
CONTRACT – All goods are sold subject to this agreement, which constitutes the whole contract between the parties.
OWNERSHIP AND RISK – Ownership of goods does not pass to the Debtor until full payment is received. Risk passes to the Debtor immediately on dispatch from Citilec warehouse.
PRICES AND PAYMENT – Credit accounts are payable within 30 days of statement date. Interest of 2% per month applies to overdue accounts. The Debtor consents to the jurisdiction of the Magistrate's Court. The Debtor is liable for all legal costs of collection.
EARLY SETTLEMENT DISCOUNT – Strictly 7 days from date of invoice as per agreed terms. Discount is forfeited on late payment.
CREDIT LIMIT – The credit limit granted by Citilec is at its sole discretion and may be amended without notice. The Debtor remains liable for all goods supplied regardless of credit limit.
DELIVERY – Delivery dates are estimates only. Delivery is within Gauteng. Delivery outside Gauteng is for the Debtor's account. Payment is on actual quantity delivered. Claims for shortage must be made within 24 hours of invoice date.
RETURNS – No goods will be accepted for return without prior written consent. A handling fee of 15% (or higher if levied by Citilec's supplier) applies to all returns.
CESSION OF BOOK DEBTS – The Debtor cedes all rights to book debts to Citilec as security for amounts owing.
GENERAL PROVISIONS – Failure to enforce any term is not a waiver of rights.

Deed of Suretyship

The undersigned sureties bind themselves jointly and severally as surety and co-principal debtor with the Debtor for the due payment of all amounts now or hereafter owed by the Debtor to Citilec (Pty) Ltd from whatsoever cause arising. This suretyship shall be a continuing guarantee and shall not be cancelled or revoked without Citilec's written consent.

Each surety acknowledges that they have read and understood this Deed of Suretyship. The signed original must be witnessed and submitted to Citilec.

Full Name of Surety

ID Number

Full Name of Surety

ID Number

Full Name of Surety

ID Number

Declaration

I, the undersigned, in my capacity as authorised representative of the Debtor and in my personal capacity:

I hereby warrant that I am duly authorised by the Debtor to make this application on its behalf and that all information provided is true and correct.

I accept and agree to the Standard Conditions of Sale which form part of this credit application, and acknowledge having read and understood them in full.

I/We acknowledge and accept the terms of the Deed of Suretyship above and understand that I/we are personally liable as surety and co-principal debtor for all amounts owing by the Debtor to Citilec.

I hereby consent to Citilec (Pty) Ltd performing a credit check and utilising any information contained herein, including disclosure to any credit bureau for the purposes of assessing creditworthiness and reporting account conduct.

Print Name *

Capacity *

Signed At (City)

Supporting Documents Required

Please upload copies of the following documents. A signed original must also be submitted to your nearest Citilec branch.

Company / CC documents (CoR)
VAT registration certificate
Identity documents of all directors/members/partners
Proof of residential address of all directors/members/partners
3 months' recent bank statements
Latest audited or reviewed financial statements

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