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(03) 8373 1600
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SECTION 1 – APPLICANT DETAILS
Trading Name:
(Required)
ABN:
(Required)
Trust Name (If applicable):
Legal Name:
(Required)
ACN:
Entity Type:
(Required)
Company
Sole Trader
Partnership
Trust
Nature of Business:
(Required)
Date Commenced:
(Required)
DD slash MM slash YYYY
No. Employees:
(Required)
Postal Address:
(Required)
State & Postcode:
(Required)
Delivery address is same as postal address
(Required)
Yes
No
Delivery Address:
State & Postcode:
Phone:
(Required)
Accounts Phone:
(Required)
Fax:
Accounts Fax:
Email:
(Required)
Accounts Email:
(Required)
Purchasing Contact:
(Required)
Accounts Contact:
(Required)
PO No. Required:
(Required)
Yes
No
Partner, Sole Trader, Director or Trustee details:
Name
Residential Address
Date of Birth
1
(Required)
Untitled
(Required)
Untitled
(Required)
2
Untitled
Untitled
3
Untitled
Untitled
4
Untitled
Untitled
Has any Shareholder, Director, Partner or Trustee been declared bankrupt or been a Shareholder, Director, Partner, Principal or Trustee of any entity wound up or subject to a scheme of arrangement with creditors or under official management?
(Required)
Yes
No
If yes, please provide further details and attach it to this application. Additional details may be required at a later date.
Bank Details
Account Name:
(Required)
BSB:
(Required)
Name of Bank:
(Required)
Account Number:
(Required)
SECTION 2 – CREDIT LIMIT REQUIRED
Estimated Monthly Purchases:
(Required)
SECTION 3 – TRADE REFERENCES
Supplier 1:
(Required)
Branch:
(Required)
State:
(Required)
Phone:
(Required)
Fax:
(Required)
Email:
(Required)
Supplier 2:
(Required)
Branch:
(Required)
State:
(Required)
Phone:
(Required)
Fax:
(Required)
Email:
(Required)
Supplier 3:
(Required)
Branch:
(Required)
State:
(Required)
Phone:
(Required)
Fax:
(Required)
Email:
(Required)
SECTION 4 – CREDIT ACCOUNT TERMS & CONDITIONS
Consent
(Required)
I agree to the
CREDIT ACCOUNT TERMS & CONDITIONS
and also warrant that the information given in this application is true and correct at the date of signing.
SECTION 5 – ACKNOWLEDGMENT
I/We being the authorised person of (Applicant)
Untitled
(Required)
have read, understood and hereby agree to adhere to and be bound by the Conditions stated in Section 4 of this Contract and also warrant that the information given in this application and annexures hereto is true and correct at the date of signing.
Who must sign this Agreement on behalf of the Customer:
For Companies:
Where there is only one director for the company then that person must sign; where there are two or more directors for the company then two (2) Directors or a Director & Company Secretary must sign.
Sole Traders operating under their own name or under a business name:
The individual.
Partnerships:
All Partners of the Partnership.
Where this is not possible please contact the SPFA office.
Signatory
Independent Witness
Signature
(Required)
Signature
(Required)
Name:
(Required)
Name:
(Required)
Position:
(Required)
Position:
(Required)
Date:
(Required)
DD slash MM slash YYYY
Date:
(Required)
DD slash MM slash YYYY
Signatory
Independent Witness
Signature
Signature
Name:
Name:
Position:
Position:
Date
DD slash MM slash YYYY
Date
DD slash MM slash YYYY
PERSONAL GUARANTEE AND INDEMNITY
WARNING: THIS IS AN IMPORTANT DOCUMENT. IF YOU DO NOT UNDERSTAND THIS DOCUMENT YOU SHOULD SEEK INDEPENDENT LEGAL ADVICE. IMPORTANT: As part of your application for credit, this Personal Guarantee and Indemnity Agreement must be completed and signed by all Directors, Sole Traders and Business Partners in the presence of Independent Witnesses (not Spouses/Partners or Family Members). Spouses/Partners of all Directors, Sole Traders and Business Partners can only sign as Guarantors in the presence of independent witnesses where there is joint ownership of personal assets.
I/We, the Guarantor(s),
Insert Guarantor(s) names as applicable*
have requested the supplier to supply
Insert Company/Partnership/Sole Trader Name
Trust Name (if a Trust)
Insert Trust Name
Trading as (if applicable)
Insert Registered Business Name
(the “Customer”) of
Insert Registered Address (not PO Box)
Consent
I agree to the
PERSONAL GUARANTEE AND INDEMNITY
Certificate of Guarantee – Executed as a Deed
Acknowledgment
By signing below as Guarantor(s), I/we certify that I/We understand the terms of this Guarantee. In particular, I/we understand that if the Customer fails to make any required payments to SPFA may recover the amount of these payments from me/us personally. In such case, SPFA may, amongst other recovery rights, take a charge over any Real Property.
I/We certify that I/We have had the opportunity of taking independent legal advice in relation to the meaning and effect of this Guarantee.
All Directors, Sole Traders, Business Partners and any other Guarantors complete, print and sign below as Guarantors in the presence of Independent Witnesses (not Spouses or Family Members).
Guarantor
Independent Witness
Signature
Signature
Name:
Name:
Address:
Address:
Date
DD slash MM slash YYYY
Date
DD slash MM slash YYYY
Guarantor
Independent Witness
Signature
Signature
Name:
Name:
Address:
Address:
Date
MM slash DD slash YYYY
Date
MM slash DD slash YYYY
Guarantor
Independent Witness
Signature
Signature
Name:
Name:
Address:
Address:
Date
DD slash MM slash YYYY
Date
DD slash MM slash YYYY
Guarantor
Independent Witness
Signature
Signature
Name:
Name:
Address:
Address:
Date
DD slash MM slash YYYY
Date
DD slash MM slash YYYY
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