credit account application - Office National

THE BOSS SHOP OFFICE NATIONAL BROOME
Locked Bag 4003
26 Clementson Street
Broome WA 6725
Ph: 08 9192 2354 Fx: 08 9192 2429
Email: accounts@the-boss-shop.com.au
CREDIT ACCOUNT APPLICATION
Trading Name:
Business Name:
ABN No:
Delivery Address:
Post Code
Postal Address:
Post Code
Phone No: Fax No: Mobile No:
E-mail:_________________________________________
Accounts Contact:
Phone No:
Sole Trader Partnership Company Government
Nature of business:
How long in business:
Credit Limit Required:
Bank Branch Phone No
Trade References:
Business Name Contact Phone No Fax No
1.
2.
3.
Proprietors/Directors
(If more than two Proprietors/Directors, please indicate on a separate page)
Surname:
Private Address:
First Names:
Phone No: Property Owned: YES / NO
Surname:
Private Address:
First Names:
Phone No: Property Owned: YES / NO
COOLGEM HOLDINGS PTY LTD
ACN 091 318 393 ABN 42 970 371 806

THE BOSS SHOP OFFICE NATIONAL BROOME
Locked Bag 4003
26 Clementson Street
Broome WA 6725
Ph: 08 9192 2354 Fx: 08 9192 2429
Email: accounts@the-boss-shop.com.au
CREDIT ACCOUNT APPLICATION DECLARATION
I/We certify that the above information is true and correct and it is on this basis that we
submit this Application for a Credit Account with Broome Office Supplies and Services. I/We
agree to adhere to your conditions of trading and settlement of accounts. Our terms of credit
are strictly 30 days from date of statement, if our account runs into 45 days then credit will be
stopped. I/We also undertake to pay all charges incurred in collecting monies due on
account.
I/We acknowledge that we are responsible for notifying Broome Office Supplies and Services
in writing if we wish the account to be marked “Order Number Only” or “Type Name in
Reference” for each invoice. The normal trading terms do not require the above.
Signature:
Signatory Title:
Date:
COOLGEM HOLDINGS PTY LTD
ACN 091 318 393 ABN 42 970 371 806