Credit Application Form

To be completed by Applicants – please complete all sections and read the Terms and Conditions of Trade overleaf
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COMERCIAL CLIENTS ONLY

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DETAILS OF OWNER (if Sole Trader) PARTNERS (If Partnership) OR DIRECTORS (If Company)

TRADE REFERENCES

I certify that the above information is true and correct and that I am authorised to make this application for credit. I have read and understand the TERMS AND CONDITIONS OF TRADE (overleaf or attached) of A & L Concrete Pumping Pty Ltd T/A Citywest Concrete Pumping 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. I authorise the use of my personal information as detailed in the Privacy Act clause therein. I agree that if I am a Director/Shareholder (owning at least 15% of the shares) of the Client I shall be personally liable for the performance of the Client’s obligations under this contract.
Clear Signature
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