Korg UK LTD - Preliminary Account Evaluation Form

Thank you for contacting Korg to request an account with us.

Before we are able to start the process please can you complete and submit this form.

Trading Name

Please ensure that you give us your full correct address as any omissions will delay the application

Address Postcode Country

Please ensure that you give us your full correct address as any omissions will delay the application Invoice Address if different Invoice Address Postcode Country

Telephone Main Contact Main Contact Mobile Email Address Accounts Contact Accounts Email Address Website URL Twitter Facebook How Long Established Amount of Credit Requested

Section B - To be completed by Limited Companies only

Company Name Registered Office Address Postcode Country Company registration No

Section C - To be completed by Sole Traders/Partnerships only Name 1 Position Telephone Name 2 Position Telephone Main Address Postcode Country Previous Address if at current address less than 3 years Postcode Country

Section D - To be completed by all applicants

PLEASE SUPPLY THREE TRADE REFERENCES

Contact Name Company Name Email Telephone

Section E - To be completed by all applicants

What is the nature of your business? (Please tick all that apply)

General Music / Guitar / Bass Hi Tech / Keyboards / DJ Drums & Percussion PA / Pro Audio Traditional / Brass / Woodwind Specialist Description of premises Shop Square Footage

What Korg UK brands are you interested in? (Please tick all that apply)

Korg Vox Takamine Mapex Paiste Vic Firth Kickport Soundbrenner

Competitors brands stocked

(e.g. Roland / Yamaha / Line 6 / Pearl / Sabian etc)

What is your target market? (Please tick all that apply)

Education Retail Internet Mail Order Export Other Number of branches Number of employees Anticipated annual turnover Additional comments

Please note; This document is not an automatic confirmation of acceptance.

Korg UK Limited reserve the right to refuse application requests at any time.

Should this initial enquiry be successful, an Area Manager will contact you to conduct a site evaluation and commence the credit application process.