About this application

Credit provided by

Safelincs Ltd
33 West Street
Alford
Lincolnshire
LN13 9FX

Electronic Signature Required

Because this is an online application, you will not be able to provide a written signature. Selecting the signature checkbox at the bottom of this form will act as your signature.

Privacy

We are dedicated to taking your privacy seriously. The details you submit here will only be used as part of your credit application and, if successful, the ongoing management of your credit account.

We do not send unsolicited marketing, sell, share with third-parties or use your data in any other way. View more information in our privacy policy.

Credit Account Support

If you have any questions about this application process, please contact us using the details below.

Telephone: 01507 464 164
Email: creditaccount@safelincs.co.uk

Accounts Department

If you have a query regarding your payment to your account, please contact our accounts department directly.

Telephone: 01507 464 443
Email: accounts@safelincs.co.uk

Customer Credit Account Application Form

Required fields are marked *

Main Contact

Name *

Job Title *

Email *

Telephone Number *

Invoice Contact

Name *

Job Title *

Email *

Telephone Number *

Invoice Address (if different to registered address)

Bank Reference

Bank Name *

Length of Time With Bank *

Account Number *

Sort Code: *

Bank Address *

Application Information

If you have already spoken to a member of staff at Safelincs, please enter their name below

What kind of products are you interested in purchasing? *

Digital Signature *

Note: this signature will be used in place of a traditional written signature. This form cannot be submitting unless you use this checkbox to act as your signature.