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New Customer & Existing Customer Application Form

This form should be used to submit an application for a new customer account, (to amend details for an existing account please contact your Yara Area Manager). Please note that account creation may take up to 4 working days.

Is this application for a new customer?

Yes

No

Is this an existing customer application?

Yes

No

Please provide the Sold To Account Number

Customer Details

Company name

Trading name (if different)

Trading address - Street

City

County

Postcode

Country

United Kingdom

Ireland

Other

Please specify country

Add additional addresses (if different)

Ship to or Delivery Address

Bill to

Payer

Buying group

Ship to or Delivery address

Name

Contact

Street address

City

County

Postcode

Country

Phone number

Email

Bill to address

Name

Contact

Street address

City

County

Postcode

Country

Phone number

Email

Payer address

Name

Contact

Street address

City

County

Postcode

Country

Phone number

Email

Buying group address

Name

Contact

Street address

City

County

Postcode

Country

Phone number

Email

Account Type

What is the purpose for the account?

Fertiliser and Nutrition

Industrial and Environmental

Analysis or Soil Sample

Yara Contacts

Yara Area Manager

Yara Agent

Yara Sales Manager

Yara Sales Manager

Account Details

Payment method

Direct Debit - One month - 28th of month following delivery

Direct to Bank - BACS - 21st of month following delivery

Payment method

Direct Debit - One month - 28th of month following delivery

Direct to Bank - BACS - 21st of month following delivery

Direct Debit - Split 3 months - Starting 28th of month following delivery (Not available to Buying Group members)

Payment method

Direct Debit - One month - 21st of month following delivery

Direct to Bank - BACS - 21st of month following delivery

Payment method

Direct Debit - One month - 21st of month following delivery

Direct to Bank - BACS - 21st of month following delivery

Payment method

Direct to Bank - BACS - 21st of month following delivery

*Cheques no longer accepted

Download Direct Debit mandate

Please download, print, complete and sign the above mandate and then email a photo or scanned copy to OTC.CentralEurope@yara.com

Download Direct Debit mandate

Please download, print, complete and sign the above mandate and then email a photo or scanned copy to OTC.CentralEurope@yara.com

Download Direct Debit mandate

Please download, print, complete and sign the above mandate and then email a photo or scanned copy to OTC.CentralEurope@yara.com

Download Direct Debit mandate

Please download, print, complete and sign the above mandate and then email a photo or scanned copy to OTC.CentralEurope@yara.com

Download Direct Debit mandate

Please download, print, complete and sign the above mandate and then email a photo or scanned copy to OTC.CentralEurope@yara.com

Download Direct Debit mandate

Please download, print, complete and sign the above mandate and then email a photo or scanned copy to OTC.CentralEurope@yara.com

Download Direct Debit mandate

Please download, print, complete and sign the above mandate and then email a photo or scanned copy to OTC.CentralEurope@yara.com

Download Direct Debit mandate

Please download, print, complete and sign the above mandate and then email a photo or scanned copy to OTC.CentralEurope@yara.com

I have completed and emailed a direct debit mandate

Credit limit

Legal status

Partnership

Sole Trader

Limited Company

Unlimited company

Registered Charity

Trust

PLC

Buying Group

Other

Number of partners

2

3

4 or more

Premises owned or rented

Owned

Rented

Company registration number

Please explain

Are you VAT registered

Yes

No

VAT number

Please explain

EORI Number (Northern Ireland only)

Proprietor details

Proprietor FULL name

Date of Birth

Proprietor FULL address

proprietor_postcode

Partner 1

Partner 1 FULL name

Date of birth

Partner 1 FULL address

Partner 1 postcode

Partner 2

Partner 2 FULL name

Date of birth

Partner 2 FULL address

Partner 2 postcode

Partner 3

Partner 3 FULL name

Date of birth

Partner 3 FULL address

Partner 3 postcode

Partner 4

Partner 4 FULL name

Date of birth

Partner 4 FULL address

Partner 4 postcode

If there are more than 4 partners please use 'additional information' box

Primary Contact Details

Contact name

Email

Telephone

Mobile

Add additional contact details (if different)

Commercial

Accounts

Safety Data

REACH

EP Contact

Commercial Contact Details

Contact name

Email

Telephone

Mobile

Accounts Contact Details

Accounts contact

Email

Telephone

Mobile

Safety Data Contact Details

Safety contact (for safety data sheets)

Email

Telephone

Mobile

REACH Contact Details

reach_contact_name

Email

Telephone

Mobile

Explosive Precursor Contact Details

EP Contact (for ID verification)

Name

Email

Mobile

Telephone

If you would like to receive confirmations and invoices via post, please check this box. All confirmations and invoices will be sent electronically to the primary email address given unless otherwise stated.

Additional Information

Submission and Confirmation Details

I consent that by submitting this form:

1. I am authorised to submit this application form on behalf of the Company/Proprietor named above.

2.Any purchase orders placed with Yara UK Limited will be governed by Yara's General Terms and Conditions of Sale, which will apply to exclusion of any other terms unless expressly agreed to by Yara in writing. Yara’s General Terms and Conditions of Sale can be viewed HERE.

3. I am providing personal data that Yara will process in accordance with the Yara Privacy Policy. In particular, I acknowledge that Yara UK Limited may process and disclose my personal or financial data to credit reference agencies, banks and credit insurers in relation to any credit which may from time to time be afforded by Yara UK Limited and that such organisations may process the data provided. Yara’s Privacy Policy can be viewed HERE.

Yes! I would like to receive invitations, offers and updates related to Yara products, services and events via email and SMS as further described in the Consent declaration for Digital Marketing. Each email and SMS will include a link for unsubscribing from this service.

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Pocklington Industrial Estate
Pocklington
York
YO42 1DN

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