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BRIMA Experience
About Us
Service Offering
Courier
Enterprise Logistics
Freight
Track
Route Guide
Careers
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Open An Account.
Credit Application
Step
1
of
3
33%
REGISTERED NAME OF APPLICANT (INDICATE IF A (PTY) LTD/CC/PARTNERSHIP
REGISTRATION NUMBER OF APPLICANT
FULL TRADING NAME OF THE APPLICANT
HOLDING COMPANY AND ADDRESS APPLICABLE
VAT REGISTRATION NO.
TELEPHONE NO.
EMAIL ADDRESS
DELIVERY ADDRESS (DOMICILIUM ADDRESS)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
BOX NO.
MEMBERS / DIRECTORS / PARTNERS FULL NAMES AND ID NUMBERS
1.
ID NO.
2.
ID NO.
3.
ID NO.
PLEASE STATE IF APPLICANT OR ANY DIRECTORS / MEMBERS / PARTNERS HAVE BEEN DECLARED INSOLVENT OR HAVE AFFECTED A SCHEME OF COMPROMISE WITHY ANY CREDITOR
YES
NO
IF YES, GIVE DETAILS OF TRUSTEES / LIQUIDATOR:
(Required)
DATE BUSINESS PURCHASED OR ESTABLISHED
MM slash DD slash YYYY
NATURE OF TRADING ACTIVITIES
IMPORTER / EXPORTER CODE
BANK NAME
ACCOUNT NO.
BRANCH NAME
BRANCH TELEPHONE NO.
PREMISES
OWNED
RENTED
IF NOT OWNED, PLEASE STATE NAME & ADDRESS OF LANDLORD
PERSON/S NAME RESPONSIBLE FOR PAYMENT
TEL NO.
EMAIL ADDRESS
CREDIT LIMIT REQUIRED
AUDITORS NAME
AUDITORS ADDRESS
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
AUDITORS TEL NO.
SUPPLIERS
NAME OF SUPPLIER & ADDRESS
AVG MONTHLY PURCHASE
TERMS
ACCOUNT NO.
TEL NO.
Add
Remove
Name
Designation
Date
MM slash DD slash YYYY
CREDIT APPLICATION REQUIREMENTS CHECKLIST
Fully Completed Credit Application Form
Max. file size: 64 MB.
Company Registration Documents (Cipro Documents)
Max. file size: 64 MB.
Identity Documents of Directors
Max. file size: 64 MB.
Proof of Address
Max. file size: 64 MB.
VAT 103 Certificate
Max. file size: 64 MB.
Tax Clearance Certificate
Max. file size: 64 MB.
Banking Confirmation Letter
Max. file size: 64 MB.
Signed Rates
Max. file size: 64 MB.
Signed Service Level Agreement
Max. file size: 64 MB.
STANDARD TRADING CONDITIONS
The Applicant acknowledges that they have read and understood and hereby accepts and agrees to the following Conditions. 1. It is warranted that the information furnished above is true and correct in every respect. 2. The Applicant undertakes to notify BRIMA LOGISTICS (herein after referred to as “Brima”) in writing and within 24 hours, of any change of address, failing which any credit facility granted to it shall be cancelled forthwith. 3. Upon the signature of this credit application the Applicant agrees to be bound by the terms incorporated herein. 4. The credit amount shall be payable thirty (30) days from date of statement. 5. If payment of any particular credit amount made is overdue, the Applicant will be charged interest on the overdue amount at the rate of prime plus 2% charged by Brima’s bank and which interest shall be calculated and compounded monthly in advance from the due date to the date of final payment. 6. Should: 6.1 The Applicant breach the terms of this agreement, and should the Applicant fail to remedy its breach within 7 days of receiving written notice to rectify such breach then Brima shall be entitled, without prejudice to any right it has in law and in its sole discretion, to institute action against the Applicant; 6.2 The parties to this agreement consents to the jurisdiction of the Magistrate’s Court in terms of Section 45 of Act 32 of 1944 as amended; 6.3 Notwithstanding the aforegoing, Brima shall not be obliged to institute action against the Applicant in the Magistrate’s Court and the Applicant hereby submits to the jurisdiction of the High Court of South Africa, in respect of any action instituted against the Applicant by Brima. 7. Brima shall not be obliged to take insurance on any goods handled or stored by it except, upon express prior instruction given in writing by the applicant. Should the applicant require the said insurance, it is specifically agreed that all insurances taken by Brima shall be subject to the usual expectations and conditions of the policies of the insurance company or the underwriters taking the risk. 8. This Credit Agreement can be terminated by the Applicant on 30 days written notice to Brima. Should the Applicant elect to terminate this agreement in term of this clause, all amount then due shall fall due owing and payable. 9. A certificate issued under the hand of a Director shall be prima facie evidence of the amount due by the Applicant and such certificate shall be sufficient for purposes of Summary Judgment or Provisional Sentence. 10. In the event of Brima handing over the applicant’s account to an attorney for collection (whether action is instituted or not), the Applicant agrees to pay costs on the attorney and own client scale, including collection commission payable in terms of law. 11. In this agreement, unless the context otherwise requires, the words importing the singular shall include the plural and vice versa. 12. The Applicant agrees to notify Brima in writing within seven (7) days of any change in ownership of its business, or should it be a company, any share transaction where the majority shareholding is affected, failing which any credit facility granted shall be deemed forthwith to be cancelled. 13. In the event of an order being given to Brima on the Applicant’s official order form, the Applicant shall be stopped from denying the validity of such order notwithstanding the fact that such order may have been given or signed by a person not authorised by the Applicant. 14. The Applicant agrees that any latitude or indulgence whatsoever which Brima may grant the Applicant in respect of any of its obligations under this agreement, will not be construed as a waiver of any right that Brima may otherwise have against the Applicant. 15. Any condonation of any breach of any of the provisions hereof or other act or relaxation, indulgence or grace on the part of Brima shall not in any way operate as or be deemed to be a waiver by Brima of any rights under this contract or be construed as a novation thereof. 16. This contract contains the entire agreement between Brima and the Applicant and any other terms, provisions, conditions or cancellations thereof whether express or implied are excluded herefrom and any variations, alterations or additions to this contract shall be of no force or effect or legally valid unless reduced to writing and signed by Brima and the Applicant. 17. The Applicant and Brima chooses as their domicilium citandi et executandi the address as set out herein.
Terms and Conditions
I agree to the terms and conditions.
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