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CONTACT
Credit Account Application
Step
1
of
4
25%
Please complete the following business details to begin your credit account application.
Business Details
Customer's Full or Legal Name
(Required)
Trading Name (if different from above)
Type of Organization
(Required)
Sole Trader
Partnership
Limited Company
Trust
Others
NZBN
Date of Incorporation
GST No (Enter Nil if not GST registered)
(Required)
Nature of Business
Billing Address
Billing Address
(Required)
Street Address
Address Line 2
City
ZIP / Postal Code
Physical Address / Default Delivery Address (if Different from Billing)
Street Address
Address Line 2
City
ZIP / Postal Code
Telephone
(Required)
Accounts Payable and Invoicing
Purchasing Contact Name
Purchasing Phone
Purchasing Email
Account Payable Contact Name
(Required)
Accounts Phone
(Required)
Accounts Email
(Required)
Details of Owner / Directors
Director’s (if Company)/ Partner’s (if Partnership)/ Owners (if Sole Trader)
Principal Director / Representative
Principal Full Name
(Required)
First
Last
Principle Position
(Required)
Director
Partner
Proprietor
CEO / MD
CFO / Finace Manger
Manager
Principal Mobile
(Required)
Principal Email
(Required)
Secondary Director / Representative
Secondary Director / Representative (If applicable)
First
Last
Secondary Director / Representative Position
Director
Partner
Proprietor
CEO / MD
CFO / Finace Manger
Manager
Secondary Director / Representative Mobile
Secondary Director / Representative Email
Trade / Business references – (3 major suppliers)
Company Name 1
(Required)
Contact Name 1
(Required)
Telephone 1
(Required)
Company Name 2
(Required)
Contact Name 2
(Required)
Telephone 2
(Required)
Company Name 3
(Required)
Contact Name 3
(Required)
Telephone 3
(Required)
Once submitted, we will generate a PDF containing the information you provide and send it to you for review and signature. Please note that this is not the final credit agreement. The final application, together with our Terms and Conditions, will be provided separately for signing.
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