Trading Account | Advanced Living Solutions

REQUEST FOR TRADING ACCOUNT

Application Date *

CUSTOMER INFORMATION

Business/Trading Name *

ABN *

ACN *

Date Registered *

Trading Address *

Suburb *

State *

Post Code *

Phone *

Fax *

Email *

Postal Address *

Suburb *

State *

Post Code *

COMPANY TRADE REFERENCES

Reference Name *

Phone *

Email *

Reference Name *

Phone *

Email *

Reference Name *

Phone *

Email *

Requested Credit Amount

Requested Credit Amount *

DIRECTOR/PARTNERS/SOLE TRADER DETIALS

Director 1

Director Name *

Position *

Private Address *

Suburb *

State *

Post Code *

Director 2

Director Name

Position

Private Address

Suburb

State

Post Code

Director 3

Director Name

Position

Private Address

Suburb

State

Post Code

TERMS & CONDITIONS

All accounts with an outstanding balance must be settled within 30 days from the end of month from the date that appears on the invoice.
Should the Customer default in payment, liquidated damages may be charged at the current Commonwealth Bank of Australia overdraft rate and an account-keeping fee of $20.00 per month may be applied until the outstanding balance is paid.
If a customer does not pay the outstanding balance within the trading terms, then any expenses, costs or other disbursements incurred by the Supplier in recovering monies must be paid by the Customer.
The Supplier retains ownership of any goods provided to the Customer until payment in full is received by the Supplier from the Customer.
The Customer agrees that entries in the records of the Supplier stating that the Customer has requested the supply of certain goods and/or services and that the Supplier has delivered the said goods and/or services to the Customer, shall be prima facie evidence of such request and delivery.
This request for a trading account and any contract for the supply of goods and/or services to the Customer shall be governed by the Law of Victoria.
In the even that the Customer is a company (not listed on a recognised Stock Exchange) the Customer must forthwith procure not less than two of its directors (or the sole director if a sole director company) to execute a Guarantee and Indemnity of the obligations of the Customer in the form of the Guarantee and Indemnity at the end of this form.

PRIVACY ACT ACKNOWLEDGEMENT AND CONSENT

The customer grants to the supplier or their agent to:

Disclose to a credit reporting agency certain personal information about me/us including identify particulars, the amount of credit applied for; payments which may be more then 60 days overdue; and serious credit infringement which the credit provider believes has been committed
Obtain from a credit reporting agency a report containing personal information about me/us and, a report containing information about my/our commercial activities of commercial credit worthiness, to enable the credit provider to assess this application for credit.
Give to and obtain from any credit provider(s) that may be named in this application or in a report held by a credit worthiness, credit standing, credit history, credit capacity for the purpose of assessing an application for credit or notifying any default by me/us

This consent shall remain in force so long as there is an amount owing to the credit provider

The undersigned certifies that the information herein is true and correct and that the undersigned is authorised to sign on behalf of the customer and to accept the terms and conditions herein.

Print Name *

Date *

GUARANTEE & INDEMNITY

We,

Names of Directors *

Addresses of Directors *

In consideration of the Supplier considering the within names Customer’s requests for a trading account DO HEREBY for ourselves our executors and administrators jointly and severally GUARANTEE the due and punctual performance and observance by the Customer of the due and punctual payment by the Customer of the money owed and other money payable there under and we HEREBY DECLARE that this Guarantee shall be a continuing Guarantee and shall not be determined by the death of any one of us or notice of such death and neither the neglect of the Supplier to enforce any remedy in respect of the breach of the said conditions or non payment of the money owed and any other money payable by the Applicant respectively nor time given to the Customer by the Supplier shall cease or exonerate or in any way affect our liability hereunder.

IN WITNESS whereof we have hereunto set our hands and seals this *

day of *

SIGNED SEALED AND DELIVERED by

the said in the presence of:

Witness Name *

SIGNED SEALED AND DELIVERED by

the said in the presence of:

Witness Name *

REQUEST FOR TRADING ACCOUNT

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