Application for credit in lieu of Lobina Premium services

Full Company Name

Full Company Name OR Inidividual Name(Required)

Trading or Client Name (If different from above)

Nature of Business(Required)

Registered Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Quintessentially Member Number

Company Registration Number (if applicable)

VAT Registration Number (if applicable)

Trading Address (if different from above)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Phone Number(Required)

Email(Required)

Accounts Department Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Please provide contact details for who we send booking confirmation to:

Name

First Last

Phone Number

Email

Name

First Last

Phone Number

Email

Name

First Last

Phone Number

Email

Accounts & transaction authorisation:

Account Contacts Name

First Last

Account Contacts Phone Number

Account Contact Email

Account Contacts Name

First Last

Account Contacts Phone Number

Account Contact Email

Transaction Options

Credit Limit Sought(Required)

Transaction Currency(Required)

Signature(Required)

Name(Required)

First Last

Date(Required)

Position(Required)

CAPTCHA

Prohibited Cargo

Lobina will not carry any items prohibited by applicable shipment laws. These include, but are not limited to, contraband such as illicit drugs or weapons, ammunition or explosives, radioactive materials, live animals or fresh produce. Please refer to Lobina’s full terms and conditions before requesting Lobina Premium services. We will issue these terms and conditions in full upon accepting your application, and you must accept them before we proceed.

Download Form for Posting

Alternatively, completed forms can be downloaded by clicking below and posting to Postal Address:

Lobina Transport Services Ltd,
Nutbrook House,
Shipley Common Lane,
Ilkeston,
Derbyshire DE7 8TP

Download PDF

Request more information

Application for credit in lieu of Lobina Premium services

Full Company Name

Please provide contact details for who we send booking confirmation to:

Accounts & transaction authorisation:

Transaction Options

Prohibited Cargo

Download Form for Posting

Lobina has a long standing reputation for saying yes and for continuously delivering on its promises