A report completely researched from scratch. This report includes a full assessment with the director and trade references. There are no financials, contracts, trade data and director assessments included. Business CIPC, Business Score, Business Adverse (Judgments, Defaults etc.), Business Deeds, Business Trade References , Director (application signatory) assessment, Principal Detail , Principal Deeds, Principal links and affiliations, Principal Defaults, Standard Bank Code (24 hour bank code), Enquiry History

Your Contacts:

Name {{ $client->name }}

Email {{ $client->email }}

Inoxico Report Type

Quickview - R{{ $inoxicoQuick }}

Basic - R{{ $inoxicoBasic }}

Detailed - R{{ $inoxicoDetailed }}

Comprehensive - R{{ $inoxicoComprehensive }}

Debtors Details

Company Name {{ Form::text('companyName') }}

Reg Number {{ Form::text('DebtorsRegNumber') }}

Contact Number {{ Form::text('debtorContacts') }}

Email {{ Form::email('DebtorEmail') }}

Trade Reference 1

Company Name {{ Form::text('refCompany1') }}

Credit Terms applied for {{ Form::select('termRef1', [ '' => 'Please Select', '30' => '30 days', '60' => '60 days', '90' => '90 days', '120+' => '120+ days' ] ) }}

Credit Limit applied for (R) {{ Form::select('creditLimitRef1', [ '' => 'Please Select', '0-100,000' => '0-100,000', '100,000 – 250,000' => '100,000 – 250,000', '250,000 – 1,000,000' => '250,000 – 1,000,000', '1,000,000 – 5,000,000' => '1,000,000 – 5,000,000', '5,000,000+' => '5,000,000+' ] ) }}

Contact Person {{ Form::text('contactPerson1') }}

Contact Number {{ Form::text('contact1') }}

Consent obtained? {{ Form::radio('consent1', 'YES', false) }} Yes {{ Form::radio('consent1', 'NO', false) }} No

Trade Reference 2

Company Name {{ Form::text('refCompany2') }}

Credit Terms applied for {{ Form::select('termRef2', [ '' => 'Please Select', '30' => '30 days', '60' => '60 days', '90' => '90 days', '120+' => '120+ days' ] ) }}

Credit Limit applied for (R) {{ Form::select('creditLimitRef2', [ '' => 'Please Select', '0-100,000' => '0-100,000', '100,000 – 250,000' => '100,000 – 250,000', '250,000 – 1,000,000' => '250,000 – 1,000,000', '1,000,000 – 5,000,000' => '1,000,000 – 5,000,000', '5,000,000+' => '5,000,000+' ] ) }}

Contact Person {{ Form::text('contactPerson2') }}

Contact Number {{ Form::text('contact2') }}

Consent obtained? {{ Form::radio('consent2', 'YES', false) }} Yes {{ Form::radio('consent2', 'NO', false) }} No

Trade Reference 3

Company Name {{ Form::text('refCompany3') }}

Credit Terms applied for {{ Form::select('termRef3', [ '' => 'Please Select', '30' => '30 days', '60' => '60 days', '90' => '90 days', '120+' => '120+ days' ] ) }}

Credit Limit applied for (R) {{ Form::select('creditLimitRef3', [ '' => 'Please Select', '0-100,000' => '0-100,000', '100,000 – 250,000' => '100,000 – 250,000', '250,000 – 1,000,000' => '250,000 – 1,000,000', '1,000,000 – 5,000,000' => '1,000,000 – 5,000,000', '5,000,000+' => '5,000,000+' ] ) }}

Contact Person {{ Form::text('contactPerson3') }}

Contact Number {{ Form::text('contact3') }}

Consent obtained? {{ Form::radio('consent3', 'YES', false) }} Yes {{ Form::radio('consent3', 'NO', false) }} No

Banking Details

Initials / Spaces in case of Company {{ Form::text('initials') }}

Surname / Company name {{ Form::text('surname') }}

ID Number / numeric part of Company registration number {{ Form::text('idNumber') }}

Account Number {{ Form::text('accountNumber') }}

Brach Code {{ Form::text('branchCode') }}

Bank Account Type {{ Form::select('accountType', [ '' => 'Please Select', 'current' => 'current', 'savings' => 'savings', 'bond' => 'bond', 'credit card' => 'credit card', 'subscription share' => 'subscription share', 'not known' => 'not known' ] ) }}

Attach Credit Application (browse) {{ Form::file('creditApplication') }}

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