Business DetailsEntity Type Individual Sole Trader Partnership Company Trust Other Business Name*Trading Name (if different to above)Date Established (by current owners)Principle place of Business is: Rented Owned Mortgaged Australian Business Number (ABN)Australian Company Number (ACN)Delivery Address*Billing Address*Email* PhoneMobile PhoneClient DetailsApplicant #1Full Name*Date of Birth*Private Address*Drivers Licence Number*Client DetailsApplicant #2Full NameDate of BirthPrivate AddressDrivers Licence NumberAccount DetailsCredit Limit RequiredAccount Terms Required* Cash on Delivery (COD) 7 Days from invoice 14 days from invoice 7 days from end of month Accounts Contact Person*Accounts Contact Phone Number*Accounts Contact Email*Bank Name and Branch*Bank Account BSB and Account Number*Trade ReferencesPlease provide the details of three businesses for the purpose of a trade reference.Trade Reference #1Business Name*Business Email*Business Phone*Trade Reference #2Business Name*Business Email*Business Phone*Trade Reference #3Business Name*Business Email*Business Phone*Terms and ConditionsI certify that the above information is true and correct and that I am authorised to make this application for credit. I have read and understand the TERMS AND CONDITIONS OF TRADE (attached) of JK Christensen PTY LTD T/A Gourmet Food Distributors which form part of, and are intended to be read in conjunction with this Credit Account Application and agree to be bound by these conditions. I authorise the use of my personal information as detailed in the Privacy Act clause therein. I agree that if I am a director/shareholder (owning at least 15% of the shares) of the Client I shall be personally liable for the performance of the Client’s obligations under this contract.Consent* I agree to the attached terms and conditions.Terms and ConditionsName* First Last Date* DD slash MM slash YYYY
