New sales agent account application

This form should be used to submit an application for a new sales agent account, (to amend details for an existing account please contact your Yara Area Manager). 

Sales Agent Details

Country
Is the Sales Agent a FACTS qualified advisor ?
Add additional addresses (if different)

Ship to or Delivery address

Bill to address

Payer address

Buying group address

Bank Details 


Legal status

Number of partners
Premises owned or rented
Are you VAT registered

Proprietor details

Partner 1

Partner 2

Partner 3

Partner 4

If there are more than 4 partners please use 'additional information' box


Primary Contact Details

Add additional contact details (if different)

Commercial Contact Details

Accounts Contact Details

Safety Data Contact Details

REACH Contact Details

Explosive Precursor Contact Details 

EP Contact (for ID verification) 


Yara Contacts


Additional Information


Submission and Confirmation Details