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1300 139 806

Commercial Credit Application

Print and fill out the Credit Application form listed below. Once completed please fax back Credit Application to (03) 5134-6567

Please be aware that this Commercial Credit Application is treated as CONFIDENTIAL INFORMATION and is only used for this purpose.

COMPANY DETAILS:
Company Name
Business Name
A.C.N. Trading Style i.e Sole Trader or Partnership etc
Bus. Address
Postal Address
Registd. Office Co. Secretary
Years in Business Phone Number
Accounts Contact Fax Number
Purchasing Contact Email Address
Business Premises Rented Leased Owned

BUSINESS REFERENCES
a) Phone No.
b) Phone No.
c) Phone No.

BANK DETAILS
Bank Branch
Phone

PROPRIETOR/PARTNER DETAILS
Monthly Credit Req. ($)
Est. Annual Spend ($)
We hereby certify that the information supplied herein, is to the best of our knowledge, true correct and agree to abide by your trading terms as set out below.
Trading terms are strictly nett 14 days from Invoice Date.
Directors of Company or Proprietors/Partners if Sole Trader/Partnership
(1) Name (2) Name
Address Address
Contact No. Contact No.
Signature of Applicant/s
(1) (2)