Credit Application Form - Produce Company printable pdf download

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CREDIT A PPLICATION F ORM

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Produce C ompany A ccount M anager

Customer I nformation

Full C ompany N ame: _ __________________________________________________________________________________________

Trading N ame o f B usiness: _ _____________________________________________________________________________________

Limited C ompany:  I nc N o: _ _________________________ P artnership: 

Sole T rader: 

Street A ddress _ ______________________________________________________________________________________________

Phone N o: _ _________________________________

Fax N o: _ _____________________________________________

Owner E mail A ddress_______________________________________________ O wner M obile _ ______________________________

Site M anager__________________________ S ite M anager M obile _ ______________________ M ain P hone____________________

A/C’s P ayable P erson: _ ___________________________________________ P hone N o: _ __________________________________

Accounts/Statement E mail A ddress _ _____________________________________________________________________________

Paper o r E mail S tatements?(Circle)

L iquor L icence N umber___________________________Exp D ate _ ______________

Postal A ddress: _ _____________________________________________________________________________________

Delivery a ddress f or g oods _ ____________________________________________________________________________________

Companies O nly:

Directors:__________ _ ________________________________________________________________________(Insert F ull N ames)

Traded f or: _ __________ y ears N ew C ompany  F irst B usiness  B ank: _ ___________________Branch: _ ___________________

Solicitor: _ _____________________________________________Accountant:____________________________________________

Owners H ome A ddress ( If d ifferent f rom a bove)

Owners N ame: _ ______________________________________________________ O wners P hone N o: _ _______________________

Owners A ddress _ _____________________________________________________________________________________________

Credit R eferences:

We a uthorize T he P roduce C ompany t o u ndertake a t a ny t ime a ny c redit c hecks n ecessary t o d etermine s uitability a nd o ngoing

suitability o f t he a pplicant a s a n a ccount h older.

Name: _ _______________________________________________

P hone N o: _ _____________________________________

Company: _ ____________________________________________

Position:________________________________________

Name: _ _______________________________________________

Phone N o:_______________________________________

Company: _ _____________________________________________

Position:________________________________________

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Please n ote t he f ollowing b usinesses d o n ot g ive C redit R eferences: B anks, I nsurance C ompanies, P ower C ompanies, C redit C ards,

DB B reweries, L ion B reweries, C oca C ola, N Z D airy F oods, G ilmores)

25 H annigan D rive, S t J ohns, A uckland 1 072, N ew Z ealand. P h: ( 09) 6 348320 o r 0 800PRODUCE F ax: ( 09) 6 348310

Credit Application Form - Produce Company