Business Details Business/Trading Name ABN / ACN Legal Entity Name Business TypeSole TraderPty LtdTrustPartnershipGovernment Head Office Address including Suburb & Postcode Postal Address (if different) Accounts Contact Name Accounts Email Accounts Phone Operations Nature of Business Primary UseHirePurchaseBoth Hire & Purchase Main Contact for Orders Phone Email Site Delivery Address Credit Application Would you like to apply for credit terms?YesNo Credit Limit Requested Trade Reference 1 Name Company Phone Email Trade Reference 2 Name Company Phone Email Bank Details Bank Name BSB Account Number Accounts Officer Name Marketing & Consent How did you hear about us? Yes, I agree to receive product updates, occasional marketing emails, or invitations to participate in quality improvement surveys Authorisation I accept ASC's Terms & Conditions I confirm all information provided is accurate Name of Authorised Signatory Position / Title Date Signature (draw below) Clear 5 + 6 = SUBMIT APPLICATION
