Kindly tick the appropriate box* CompanySole TraderPartnershipGovernment (If subsidiary of company, name of ultimate holding company) Company Name (If company) Trading Name ABN ACN (If sole trader or partnerships fill in names and addresses of sole trader or each partner and if company fill in the names of each director) Partner 1 Same As Above Name Email Phone No Address Post Code Add Partners -+ (If sole trader or partnership, the “Customer”) Purchasing Contact Purchasing Contact Email Telephone No. Accounts Contact Accounts Contact Email Telephone No. Postal Address Invoice Address State Post Code Email Telephone No Shipping Address Same As Above Delivery Address State Post Code Email Telephone No Add Shipping Address -+ TRADE REFERENCES (other than Bankers, Real Estate Agents) Trade Reference 1 Trade Name Phone No Contact Person Email Trade Reference 2 Trade Name Phone No Contact Person Email Trade Reference 3 Trade Name Phone No Contact Person Email Amount of Credit Limit Required Per Month($) I agree to the Terms & Conditions.
