MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_01CAFC35.D827BE70" This document is a Single File Web Page, also known as a Web Archive file. If you are seeing this message, your browser or editor doesn't support Web Archive files. Please download a browser that supports Web Archive, such as Windows® Internet Explorer®. ------=_NextPart_01CAFC35.D827BE70 Content-Location: file:///C:/0C696234/Credit_Account.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Application For Credit Account

Lighting Direct Ltd <= /o:p>

PO Box 76 257

Manukau City

AUCKLAND

Phone (09) 273 3444=

Fax (09) 273 3993=

 

 

 

 

 

 
 
Application For Credit Account

 

Lighting Direct Branch:     =         &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;     

  = ;            &n= bsp;   

Nature of Organisation:          &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;               ___

 

Sole Trader  o    Partnership  o  = ;   Limited Company  o     Trust  o  = ;   Other  o          &= nbsp;           &nbs= p;            &= nbsp;

 

Trade Name:              &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;   

Legal Name:              &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;   

Delivery Addre= ss:         &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;

Postal Address:              =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =

Telephone:  (   )             =             &nb= sp;         Fax:  (   )              &n= bsp;            = ;         Mobile:  (   )              &n= bsp;            = ;       

Registered Office:              =             &nb= sp;            =             &nb= sp;            =         E-Mail:              &n= bsp;            = ;            &n= bsp;           

Company Number:              =             &nb= sp;            =             &nb= sp;            =        Date Of Birth (if sole trade= r):              &n= bsp;      

Previous Addre= ss Details (If less than 2 years):          &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;        

Identification Type:              =             &nb= sp;            =                   Identification Nu= mber:  =             &nb= sp;            =             &nb= sp; 

= Details of Partners (if partnership)

= Details of Directors (if Limited Company)

= 1 Full Name

=         = ;            &n= bsp;                    = ;         =

= 1 Full Name

=         = ;            &n= bsp;                    = ;          <= span style=3D'font-size:11.0pt;mso-bidi-font-size:10.0pt;line-height:150%; font-family:"Arial","sans-serif";mso-bidi-font-family:"Times New Roman"'>=

= Home Address

=         = ;            &n= bsp;                    = ;         =

= Home Address

=         = ;            &n= bsp;                    = ;          <= span style=3D'font-size:11.0pt;mso-bidi-font-size:10.0pt;line-height:150%; font-family:"Arial","sans-serif";mso-bidi-font-family:"Times New Roman"'>=

= Home Phone

=         = ;            &n= bsp;                    = ;         =

= Home Phone

=         = ;            &n= bsp;                    = ;          <= span style=3D'font-size:11.0pt;mso-bidi-font-size:10.0pt;line-height:150%; font-family:"Arial","sans-serif";mso-bidi-font-family:"Times New Roman"'>=

 <= /o:p>

 <= /o:p>

 <= /o:p>

 <= /o:p>

= 1 Full Name

=         = ;            &n= bsp;                    = ;        

= 1 Full Name

=         = ;            &n= bsp;                    = ;          <= span style=3D'font-family:"Arial","sans-serif";mso-bidi-font-family:"Times New= Roman"'>

= Home Address

=         = ;            &n= bsp;                    = ;        

= Home Address

=         = ;            &n= bsp;                    = ;          <= span style=3D'font-family:"Arial","sans-serif";mso-bidi-font-family:"Times New= Roman"'>

= Home Phone

=         = ;            &n= bsp;                    = ;        

= Home Phone

=         = ;            &n= bsp;                    = ;          <= span style=3D'font-family:"Arial","sans-serif";mso-bidi-font-family:"Times New= Roman"'>

 

Contact Person= for Accounts:          &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;     

Expected Month= ly Purchases:      = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;             <= /p>

Name and Branc= h of Bank:              =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =       

Bank Account Number:              =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             

Solicitors Name and Address:          &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;     

Accountants Na= me and Address:          &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;

Trade Referenc= es:      (excluding = Credit Cards, Fuel Suppliers, Landlord, Power & Phone)

1.  =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;         Phone No:                =             &nb= sp;            =      

2.  =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;         Phone No:                =             &nb= sp;            =      

3.  =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;         Phone No:                =             &nb= sp;            =      

I certify th= at the above information is true and correct and that I am authorised to make this application for credit.  In accordance with the Privacy Act (1993) I authorise any person or company = to give information as may be required in response to credit Inquiries.  I have read and understand the G= ENERAL TERMS AND CONDITIONS OF TRADE (overleaf) of Lighting Direct Ltd which form part of, and are intended to be read in conjunction with this Credit Application and agree to be bound by these conditions.=

Signed:

=         = ;            &n= bsp;            = ;            &n= bsp; 

Date:

=         = ;            &n= bsp;            = ;            &n= bsp;      

(   Proprietor    /    Partner    /    Director    /    Authorised Signatory   )  Circle One

Full Name:

=         = ;            &n= bsp;            = ;            &n= bsp;  

Position:

=         = ;            &n= bsp;            = ;            &n= bsp;      

Guarantor Details (if required):<= o:p>

Full Name:

=         = ;            &n= bsp;            = ;            &n= bsp; 

Occupation:

=         = ;            &n= bsp;            = ;            &n= bsp;      

Address:

=         = ;            &n= bsp;            = ;            &n= bsp; 

Signature:

=         = ;            &n= bsp;            = ;            &n= bsp;      

 

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© Copyright – EC Credit Control Limited - 2005

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