Online Credit Application

Company Name:

Trading Name:

Type of Business:Sole TraderPartnershipPrivate CompanyTrust

Other, please specify:

ABN:

ACN:

Date Commenced:

Nature of Business:

How Long Trading:

Postal Address:

Contact Name:

Phone:

Mobile:

Fax:

Registered Office Address:

Credit Limit Requested:

Trading Terms Requested:

Payment will be made by:EFTChequeDirect Deposit

In case of a Pty Ltd Company or Partnership - Full Name and residential address of Partners/Directors:

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Bank:

Branch:

Name on Cheque:

Current Business References (Company Name, Address, Contact No, Contact)

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