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?
Is this an existing customer application?

Customer Details

Country
Add additional addresses (if different)

Ship to or Delivery address

Bill to address

Payer address

Buying group address

Account Type


Yara Contacts


Account Details

*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


    Legal status

    Number of partners
    Premises owned or rented
    Are you VAT registered

    Proprietor details

    Partner 1

    Partner 2

    Partner 3

    Partner 4

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


    Primary Contact Details

    Add additional contact details (if different)

    Commercial Contact Details

    Accounts Contact Details

    Safety Data Contact Details

    REACH Contact Details

    Explosive Precursor Contact Details 

    EP Contact (for ID verification) 


    Additional Information


    Submission and Confirmation Details