Application for credit account and agreement

LOCK & LOAD UT(the Company) and (the Client) as named below understand this is a contract and the document comprises the credit application and the Company’s terms and conditions attached to it. This application mayinclude a guarantee/s which must be completed in full in order to process this application. If you sign the documents you will be bound by its terms. You should read the terms of the documents carefully and seek legal advice about its terms

I/We hereby apply for a Credit Account and submit the following information

Please fill the fields below - All fields are required unless stated otherwise.

Business name:

Trading address:
Suburb:
Post code:

Postal address:
Suburb:
Post code:

Business phone:
Business fax:
Mobile:

Email address:

Nature of business:
(e.g. Distributor, Accountant, Mechanic):
Approximate number of employee's:
(e.g. Distributor, Accountant, Mechanic):

Date you commenced Business under this trading name:
ABN:

Bank Name:
Branch:

Business Structure

SOLE TRADER / PARTNERSHIP (Business is not incorporated and does not have an ACN)

Registered Trading Name:

Registered Business No. BN:
State of registration:

Personal details of all registered proprietors of the trading name: (if more than 3 please attach details of extra proprietors)

1. Full name:
Home phone:
DOB:
Residential address:
Post code:

2. Full name:
Home phone:
DOB:
Residential address:
Post code:

3. Full name:
Home phone:
DOB:
Residential address:
Post code:

COMPANY / INCORPORATED ASSOCIATION

Type:

ACN(must be 9 digits):
Date of Incorporation:
State of Incorporation:

Note: If a personal / director guarantee is required, these should be included with this form and must be signed by all directors of the company

TRUST

Registered Trading Name:

Trust Type:

Trustee:

Address for Trustee:

Suburb:
Post code:

Credit Details

Estimated amount of credit per month $:
ALL accounts are strictly 7 days from date of Invoice.

Persons to contact regarding payment of the account:

1. Name:
Position:
Phone:

2. Name:
Position:
Phone:

3. Name:
Position:
Phone:

TRADE REFERENCES

Please list three trade references with which you have a credit account with. By listing a reference you authorise us to contact them to discuss your trading history and to verify your details.

1. Name:
Position:
Phone:

2. Name:
Position:
Phone:

3. Name:
Position:
Phone:

Check if you accept these terms and declaration.
(Please read carefully before submitting)