| Organisation
Details |
| Name
of Company/Business |
|
| Nature
of Business |
|
| Postal
Address |
|
| Telephone
Number |
|
| Fax
Number |
|
| e-mail
Address |
|
| Contact
Name |
|
| Payment |
| Initial
amount to be credited to account (multiples of £50 only). The
eFileit service is only available on a prepayment basis. |
£ |
A
cheque is enclosed for the above amount, made payable to "eFileit"
or
Charge to the following credit/debit card: |
|
| Cardholder's
Name (as shown on the card) |
|
| Card
Type (eg. Visa, Mastercard etc.)* *We are unable to accept American Express or Diners Club cards |
|
| Card
Number |
|
| Card
Expiry Date |
|
Card
Security Code
(last 3 digits on reverse of card) |
|
I hereby authorise
eFileit to charge the total amount due to the above credit/debit card |
| Cardholder's
Signature |
|
| Application
for an Account |
| I
hereby apply to open an eFileit account and agree to be bound by the
eFileit Terms and Conditions. (Click
here to read the Terms and Conditions).
Signature:
Full Name:
Position:
Date:
|
|
Please print out this form
and complete all sections
|
| If
paying by credit card
|
If
paying by cheque
|
Fax to 020 7583 1531
or post to:
eFileit, The London Law Agency Ltd,
69 Southampton Row,
London,
WC1B 4ET
|
Post
(together with your cheque) to:
eFileit, The London Law Agency Ltd,
69 Southampton Row,
London,
WC1B 4ET
|