Trading Name    Trading foryears
Street Address    Phone 
                    Fax 
Postal Address  Contact 

Business Type 
       Limited Company  Partnership  Sole Trader
   Registered Company Name 
Registered Office Location 

Bankers   Branch 
    Accountant    Phone 

Information about Directors/Partners in your company:
   Name                  Address                           Designation
1.   
2.   
3.   
Information about trade references: 
   Name                  Address                           Phone
1.   
2.   
3.   

               Monthly Credit Sales Expectation (GST Inc) $

   Your Email address  

I/We agree to abide by the terms of trade shown below, and acknowledge by submitting this application I/we have read, understand and agree with such terms.

I/We authorise any person or company to provide you with such information as you may require in response to your credit enquiries. I/We further authorise you to furnish any third party details of this application and any subsequent dealings that I/We may have with you as a result of this application being actioned by you.

Terms of Trade (To be read in conjunction with and applicable for credit as above)
1. Payment - All Charge Accounts are payable by the 20th of the month following the month in which the service is provided
2. Interest may be payable - Failure to pay accounts by due date shall be in breach of the agreed trading terms and the company may in respect of such outstanding account without prejudice to any other or remedies charge interest at the rate of 5% per annum above the Bank of New Zealand published commercial base lending rate per annum from the due date until the actual payment is received in full by the Company
3. Third party costs - The Customer agrees to reimburse all costs and/or expenses incurred instructing a solicitor and/or debt collection agency to recover any amount overdue for payment

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