APPLICATION FOR CREDIT ACCOUNT

APPLICATION FOR CREDIT ACCOUNT
Section 1 - Company / Personal Details
Area / Region*
Please select the store / region you will deal with most frequently.
(Please Tick)*

Sole TraderTrustLimited CompanyPartnershipOther
Trading Name / Full Name*
Legal Name
Physical Address 1*
Physical Address 2*
Company Registered Number
Drivers License Number*
A digital copy of your drivers license must be provided within this application. Please click "TAKE PHOTO" below and take 1 x picture of the front of your drivers license showing your picture. Then take 1 x selfie.
Photo of License*
Take a Selfie*
Please note: the digital ID provided must match the person completing the form. Only directors or those with the authority of the director can sign / authorise this credit account application.
Credit Amount Required
The amount you believe you will spend in a 30 day period.
Telephone

Area CodePhone Number
Mobile*

Area CodePhone Number
Email*
example@example.com
Website

Section 3 - Details of Accounts / Administration
Please provide us with the details of the person you would like to receive invoices and statements.
Contact Person Name
Email Address
example@example.com
Phone Number

Area CodePhone Number
Bank Name*
i.e. BNZ, ANZ, ASB etc
Bank Account Number*
We use bank account numbers within our accounting system to manage rules in the allocation of payments. We will not use bank account numbers for any other purpose.

Section 4 - References
Please name three references that we can contact as part of our reference checking process. New Zealand Ceiling and Drywall, TradeMax, R&S Trade, Placemakers, Dulux and Wattyl can NOT be used as references.
Trade Reference 1*
Phone - Ref 1
Email - Ref 1
Trade Reference 2*
Phone - Ref 2
Email - Ref 2
Trade Reference 3
Phone - Ref 3
Email - Ref 3

Section 5 - Certification / Signature

I certify that the above information is true and correct and that am authorised to make this application for credit. In accordance with the Privacy Act (1993) I authorise any person or company to give information as may be required in response to credit inquiries. I have read and understand the GENERAL TERMS AND CONDITIONS OF TRADE of Trade Direct Wholesale which from part of this credit application and agree to be bound by these conditions.

CLICK here to read the terms and conditions contained within our digital Credit Application.
Signed*

Clear
Date

MonthDayYear
Date
Full Name
Position
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