TO:  Accounts Payable Section, Louth County Council, County Hall, Millennium Centre, Dundalk,              Co. Louth.  Email: accountspayable@louthcoco.ie    Fax: 042 933 4549

Company Name:     _____________________________________________________________________________

 

Company Address:  _____________________________________________________________________________

 

                                   _____________________________________________________________________________

 

Contact Name:         _____________________________________________________________________________

 

Contact Number:     ________________________________  Mobile: ___________________________________

 

Email Address:         _____________________________________________________________________________

 

Tax Registration No.: ___________________________________________________________________________

Bank Details

Bank A/C No.:

IBAN No.: _______________________________________________________________________________________

 

BIC No.:  ________________________________________________________________________________________

 

Bank Name and Address:  ______________________________________________________________________

 

                                               ______________________________________________________________________

 

                                               ______________________________________________________________________

 

Authorised by:  _________________________________________________________________________________

 

Position:  ________________________________________________   Date:  _______________________________

 For Accounts Payable Use Only   
 Supplier ID                                       Tax Clear Relation                      
 PROMPT    Tax Details Received  

 

               

 

LOUTH COUNTY COUNCIL COMHAIRLE CONTAE LÚ

 

 

Sort Code: