Credit Application Form Company Name: Company Address:

Company Registration No:

VAT No:

Telephone:

Contact No:

Accounts Payable Contact:

Email Address: Type of Business: No. of Years in Business: Legal form under which the business operates: Corporate

✔

Partnership

Sole Trader

Please provide a designated contact for any required billing discussions (name and contact information): Contact Name: Contact Email:

Phone Number:

Trade References: (Please provide two credit references): Company Name 1: Address: Contact Name: Phone: Email:

Trade References (Continued):

Company Name 2: Address: Contact Name: Phone: Email:

What is your anticipated monthly spend with Europcar Ireland? Anticipated Monthly Spend €1 to €1000 €1001 to €2000 €2001 to €3000 €3001 to €5000 €5001 to €10000 €10001 to €20000

1

2

Please Tick most Relevant ✔

Credit Options (please choose one of the following) Immediate credit approval - Payment will be taken by Credit Card or payment in advance via bank transfer. (Deposit of one month’s rental will be taken prior to vehicles being supplied). 30 Day Credit Account - Payment taken by Direct Debit on the 15th of the following month. A Deposit of one month’s rental is also required and must be paid prior to vehicles being supplied.(Deposit is calculated based on initial vehicle allocation. Increase in vehicle allocation would require an increased deposit). See attached DD mandate.

Yes No

Europcar Ireland uses a credit rating company called Credit Safe to verify the company details of all new customers. If a credit rating cannot be obtained we will require a copy of the company’s latest set of Audited Accounts. Please sign to indicate that you are aware Europcar Ireland allows credit terms of 30 days. Delay of payment after 30 days will result in the vehicles being taken back by Europcar Ireland.

Name Position

SEPA BUSINESS SERVICE DIRECT DEBITS DEBTOR CONFIRMATION This Confirmation is given by the debtor named below (“Debtor”) to the creditor named below (“Creditor”) and to each paying bank of the Debtor (the “Debtor Bank”) which is in receipt of one or more direct debits (“SEPA Direct Debit(s)”) originated by the Creditor attributable to and for the account of the Debtor under and pursuant to the SEPA Core Direct Debit Scheme (“Scheme”). The purpose of this Confirmation is to facilitate the utilisation by the Debtor of SEPA Direct Debit(s) in order to pay sums owing by the Debtor in the ordinary course of its business to the Creditor. This Confirmation is governed by Irish law. The Debtor hereby irrevocably confirms to and for the benefit of the Creditor and each Debtor Bank: 1

2

(A)

That the Debtor is not a ‘consumer’ for the purposes of the Payment Services Regulations ;

(B)

That the Debtor’s right to a refund for any authorised SEPA Direct Debit shall extend only to such refund right(s) as the Debtor may have under the Payment Services Regulations, and shall not include any other right to a refund arising under the rules of the Scheme, or in any direct debit mandate given by the Debtor to the Creditor in relation to the Scheme or otherwise, or in any terms of business issued by the Debtor Bank from time to time;

(C)

That in respect of any authorised SEPA Direct Debit which has been paid by the Debtor Bank, the Debtor Bank is authorised to reject any refund request(s) from the Debtor in respect of such SEPA Direct Debit other than in the circumstances described in (B) above.

This confirmation applies only to SEPA direct debits using the Debtor IBAN(s) and Creditor ID(s) listed below.

Debtor Name:

Debtor IBAN (s)

Creditor’s Name: (Prepopulated) Creditor’s ID(s): (Prepopulated)

Please sign here: Please return to:

E

U

I

E

R

9

O

6

P

Z

C

Z

A

Z

R

1

I

1

1

R

2

E

1

L

U

R

Creditor’s Address (Pre-populated)

32

-

35

C

O

U

D

U

B

1

O

D

Date:

____________________________ E

N

2

Signature(s)

Creditor’s Name (Pre-populated)

A

P

DDMMYY

C

N

O

R

T

L

I

A

R

RR

I

R

E

L

A

T

H

W

O

O

D

,

S

A

N

T

R

Y

,

N

9

,

I

R

E

N

D

.

A ‘Consumer’ is a natural person who, in payment contracts covered under the Payment Services Regulations, is acting for purposes other than his trade, business or profession 2

EC (Payment Services) Regulations 2009 (SI No. 383 of 2009)

SEPA Business Debtor Confirmation Final V1.0

SEPA Direct Debit Mandate Unique Mandate Reference Creditor Identifier: IE19ZZZ303591 Legal Text: By signing this mandate form, you authorise (A) Europcar Ireland to send instructions to your bank to debit your account and (B) your bank to debit your account in accordance with the instruction from Europcar Ireland. As part of your rights, you are entitled to a refund from your bank under the terms and conditions of your agreement with your bank. A refund must be claimed within 8 weeks starting from the date on which you account was debited. Your rights are explained in a statement that you can obtain from your bank. Please complete all the fields below marked *

*Your Name : Your Address:

Address Line 1_________________________________________ Address Line 2_________________________________________

*City/postcode

__________________

* Country:

* Account number(IBAN) *Swift BIC *CreditorsName____Europcar_______________________________________ *Creditors Address Line1 _32-35 North wood Business Park *Address Line 2 _Santry__________________________________________ *Country _Dublin 9______________________________________________

*Type of payment Recurrent

or One-Off Payment

(Please tick √)

*Date of signing:

*Signature(s)

Please return this mandate to the creditor and not your bank

RPost eSignOff® Service

Document Signing Instructions 1. 2. 3. 4.

Read and complete the fields in this PDF. Click the “Sign Now” button below to initiate the electronic signature process. Check your inbox for a confirmation email to complete the signing process. You will receive a signed copy of the document for your records.

I accept the terms of this agreement.

Reset Form

Authorized signer's email address:

Note: You may ignore a possible PDF Reader prompt that you cannot save the data in the form. You will receive a filled out and signed copy for your records.

Sign Now

Contact RPost Support at [email protected] if you have any questions.

Developer Settings Instruction Summary (see ReadMe file for detailed instructions) 1. Attach this to the end the PDF form. . Set the parameters and register the form. . Save form and distribute. Developer Identification Number: Kunal Message Details: Message Subject: Signed Credit App Form Return signed form to this address: [email protected] Bcc the signed form to this address:

Form Options:

Click-to-Sign Send signed contract encrypted Send Registered Receipt email

✔

SLJQHU6HQW

Register Form

REGISTERED E-MAIL®, LEGAL PROOF®, eSignOff®, DIGITAL SEAL® and SIDENOTE® are registered trademarks of RPost®. Patents Granted Worldwide. Kunal-B3485A94D24C0942B4328AB7C92703E1-2C8D7FA05B2FD54D9E91ABE51517B3BA

1 1