Credit Account Application

    1. BUSINESS DETAILS


    Legal Entity:

    Other  

    Full Legal Name:

    Trading Name:

    ACN:

    ABN:

    Establishment Date:

    Years under present management:

    Class of Business:

    No of Employees:

    Business Address:

    Postal Address:

    Registered Address:

    Business Premises:

    Office Ph:

    Mobile:

    Email:

    A/C Contact:

    Position:

    Email:

    Authorised Capital: $

    Payment Terms: 30 Days from Statement

    Estimated Monthly Credit Requirements: $

    Order No. must be used:

    2. TRADE REFERENCES (Must agree to give references and your credit requirements must be similar)

    Business:

    Contact:

    Ph:

    Business:

    Contact:

    Ph:

    Business:

    Contact:

    Ph:

    3. DETAILS OF BUSINESS OWNERS/DIRECTOR:

    Full Name:

    Full Name:

    Mobile Ph:

    DOB:

    Mobile Ph:

    DOB:

    Drivers License No:

    Drivers License No:

    Private Residence:

    Private Residence:

    4. GUARANTEE & INDEMNITY (TO BE COMPLETED BY DIRECTORS OF COMPANIES)

    In consideration of the Owner providing goods and services on credit to the company named in this document, I/we (being directors of the company hereby accept personal liability jointly and severally with the company for all debts incurred by the company to the Owner and agree to indemnify the Owner in the event of non- payment by the company. I/We understand that as a result of my/our acceptance of personal liability, the Owner may recover from me/ us the total debt payable by the company the Owner from time to time. l/We acknowledge that my/our obligation shall continue until full payment of the debts, whether or not we resign or otherwise cease to be involved in the company and not withstanding any change in the payment terms of the debts incurred by the company to the Owner

    To secure the payment of all monies owing to the Owner by the company and/or by me/us hereunder I/we hereby charge with the due payment thereof all my/our right, title, estate and interest in any real property, which I/we own, both present and future, wherever located. I/We hereby appoint as my/our duly constituted attorney the Owner’s company secretary from time to time to execute in my/our name and as my/our act and deed (even though I/we may not have defaulted in carrying out my/our obligations hereunder) any real property mortgage, caveat or consent to any caveat the Owner may choose to register or lodge against my/our title to any real property in any State or Territory of Australia and I/we will indemnify and keep indemnified such attorney from and against all damages, costs, losses and expenses which such attorney may suffer or incur as a result of the exercise of the powers herein contained.

    Guarantor Full Name:

    Guarantor Full Name:

    Street Address:

    Street Address:

    Signature :

    Signature:

    Date:

    Date:

    Witness Full Name:

    Witness Full Name:

    Street Address:

    Street Address:

    Signature:

    Signature:

    Date:

    Date:

    5. AGREEMENT (All business owners/directors listed in section 3 must sign this agreement)

    1. I/We certify that the information I/We have supplied is true and correct

    2. Under the Privacy Act 1988 I/We give permission to the Owner to obtain commercial and consumer credit information about me/us from a credit reporting agency.

    3. I/We agree to the terms and conditions attached which I/we have read, understood and signed.

    Full Name:

    Full Name:

    Signature:

    Signature:

    Date:

    Date:

    Terms and Conditions

    TERMS & CONDITIONS OF HIRE

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