Account Application Form

APPLICANT INFORMATION

POS Direct Pty Ltd - ABN 68 618 244 796 (the Company) and (the Customer) as named below understand this is a contract and the document comprises the application and the Company’s terms and conditions attached to it. This application may include a guarantee/s which must be completed in full in order to process this application. If you sign these documents OR order Goods or services OR retain Goods previously provided by the Company, after receiving these documents you will be bound by its terms. You should read the terms of these documents carefully and seek legal advice about its terms.

Trading Name *

Full Legal Name *

Trading Address *

Address Line 1

City

State / Province / Region

Postal Code

Phone *

Email *

ABN *

Your Bank & Branch Name *

Are your premises *

Owned
Leased
Rented

Years trading *

CREDIT DETAILS

ALL accounts are strictly 30 days from date of Invoice

Persons to contact regarding payment: *

Position *

Email *

TRADE REFERENCES

Please list three trade references which you have a credit account with. By listing a reference you authorise us to contact them to discuss your trading history and to verify your details.

1. Business Name *

Contact Name *

Phone *

Email *

2. Business Name *

Contact Name *

Phone *

Email *

3. Business Name *

Contact Name *

Phone *

Email *

BUSINESS STRUCTURE

OPTION 1

Sole Trader / Partnership (Business is not incorporated and does not have an ACN)

Personal details of all registered proprietors of the trading name: (if more than 2 please attach details of extra proprietors)

Full Name

Phone

Date Of Birth

Driver's License Number

State

Residential Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Option 2

Company

Type

Pty Ltd (Proprietary Limited)
Ltd (limited - Public Company)

ACN

(Must be 9 digits)

If a personal / director guarantee is required, these should be included with this form and must be signed by all directors of the company

Full Name

Phone

Date Of Birth

Driver's License Number

State

Residential Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

OPTION 3

Trust

Trust Type

Name of Trustee

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

DECLERATION

Before signing this declaration please ensure you have read all terms and conditions before signing.

The Customer and each of the Guarantors have received a complete and legible copy of this Agreement and Terms and Conditions before signing it.
I/We confirm we have read, understand and agree to be bound by the Terms and Conditions of Trade as set out in the following pages.
I/We declare and warrant that the applicant/s are neither bankrupt nor insolvent and have not committed any act of bankruptcy nor traded whilst insolvent within the previous 3 years.
I/We confirm and acknowledge for the purposes of section 13 National Consumer Credit Code (“Code”), as having made this declaration before entering into this Agreement that the credit (if any) which is to be provided is to be applied wholly or predominantly for a purpose that is not a Code purpose.
I acknowledge and warrant that I am duly authorised to sign and make this application.

Full Name *

Signature *

Date *

Checkboxes *

I have read and agree to the Terms & Conditions

Phone