Credit application

Complete this form to apply for a trade credit account. Signed applications are emailed automatically to your accounts team.

Download blank PDF

Please note: No Tippex / correction tape. Black pen only. All information is required. Full names must be as per ID document. All pages must be initialled by every owner/member/director/surety where applicable. Send ID documents, company registration documents, VAT registration certificate (if applicable), proof of bank account, proof of business address, completed suretyship, and Tax Compliance Status PIN if requested.

Company details

SEP Suppliers t/a Superior Electrical · 018 285 1036 - 36 Retief St, Potchefstroom, 2520

Directors and main owners

Director / owner 1
Director / owner 2
Director / owner 3

Bank details & trade references

Company bank details
Trade references

Reference 1

Reference 2

Reference 3

Terms, declarations & signatures

I/We warrant that the information in this application is true and correct. I/We authorise the supplier to verify details with third parties and disclose account conduct to credit bureaus. Payment terms: net 30 days from statement date. Overdue amounts bear interest at 2% per month. The applicant accepts the supplier's standard conditions of sale including retention of ownership until full payment, jurisdiction of the Magistrate's Court, and liability for collection costs on attorney and own client scale.

Application declaration
Deed of suretyship
Standard conditions acceptance

Review & submit

Submitting emails the completed application to your configured addresses and opens the Shopify form below if enabled.

  • Your application is emailed automatically on submit.
  • Complete the Shopify form below so the submission is saved in Shopify admin.
  • Email supporting documents (ID, CIPC docs, VAT clearance, bank proof) to accounts if required.

Submit your application as PDF

If you downloaded the form to fill, please upload the filled form here.

Add the Shopify Forms app block here: Theme editor → this page → Credit application — Shopify Forms section → Add block → Apps → Forms → paste your Form ID.