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Online Credit Application
Credit Account Application to be Completed By Applicants
Company Name
HIRER's TRADE NAME:
DATE:
Thursday, 9 September 2010
HIRER's FULL OR LEGAL NAME:
All Hirers to Complete
Phone:
Fax:
Mobile:
Email:
Billing Address:
State:
Postcode:
Physical Address:
State:
Postcode:
Commercial Hirers Only
ABN:
Requested Credit Limit:
Date Established (ddmmyy):
Contact 1:
Position:
Phone:
Contact 2:
Position:
Phone:
Details of Owner (if Sole Trader) Partners (if Partnership) or Directors (if Proprietary Company)
Full Name:
Home Phone:
Home Address:
Full Name:
Home Phone:
Home Address:
Trade References
Business Name 1:
Phone:
Adress or A/c No.:
Fax:
Business Name 2:
Phone:
Adress or A/c No.:
Fax:
Business Name 3:
Phone:
Adress or A/c No.:
Fax:
Business Name 4:
Phone:
Adress or A/c No.:
Fax:
I certify that the above information is true and correct and that I am authorised to make this application for credit. I authorise the use of my personal information as detailed in the Privacy Act clause overleaf. I have read and understand the TERMS AND CONDITIONS OF TRADE (available in the document download section of this website) of Gillespies Cranes Nominees Pty Ltd T/A Gillespies Crane Services which form part of, and are intended to be read in conjunction with this Credit Account Application and agree to be bound by these conditions. Where the applicant is a company, partnership or trust no less than two Directors (except if a sole director), partners or trustees (except if a sole trustee) are required to sign this agreement.
Name:
Name:
Phone:
ID:
Phone:
ID:
Submit Credit Application Form
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