APPLICATION FOR COMMERCIAL
& INDUSTRIAL CREDIT

Please complete , sign and return this form along with your credit References and Financial Statement.

Name and address of Company or Sole Trader or name of Partnership:
Nature of Business:

Phone:

Registered Builder, Register No.:

ACN No.:

If Partnership or Registered Business Name, full names of Partners, Owners and private addresses.:

Name of Registered Office:

Address:

Registered with Corporate Offices at (City):

Office Nominal Capital:
Expected Monthly Purchases:
Bankers:
Four Trade References
Name 1:
City 1:
Phone 1:
 
Name 2:
City 2:
Phone 2:
 
Name 3:
City 3:
Phone 3:
 
Name 4:
City 4:
Phone 4:
Name of Contact regarding Account queries:
Name of Applicant Authorized Agent:
Position Held:
PLEASE NOTE
1. This Company offers credit terms subject to a Romalpa Clause printed on the reverse hereof.
2. Companies requiring a credit limit greater than their Paid Up Capital will be required to give Directors
Guarantees.