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  • 30 Day Credit Account

 

Application for 30 Day Credit Account

 

The Customer named hereunder hereby applies to establish a commercial credit facility with Blueborn PTY LTD T/As Dore Electrics in relation to the provisions by the supplier of goods and/or services. To enable the suppliers consideration of this application, the Customer is required to furnish the details specified below. By completing this application the customer acknowledges that he/she has read, understands and agrees to the Terms and Conditions of Sale annexed to this application. The customer warrants the accuracy of the information supplied in this application. By signing this application, the customer binds themselves to the terms and conditions of sale.

 

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DIRECTORS NAMES AND ADDRESSES
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TRADE REFERENCES
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SIGNATURE OF CUSTOMER

The information supplied on the form is necessary to enable the supplier to assess and process this application for a 30 Day credit facility. The supplier acknowledges its obligations under the Privacy Act 1988 and subsequent amendments with regards to use of information. By signing this agreement, the signatory/s confirm that he/she/they are authorised to and authorise the supplier to obtain, record and disclose information as would be reasonably expected and is deemed necessary for the purpose of commercial credit. This includes information now or in the future obtained/recorded/disclosed for the purposes of credit assessment and credit management (including default management) to or from other credit providers, debt collection agencies, trade credit insurers and other normal business providers.

 

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