Credit Application

Credit Application - Confidential
www.territorylogistics.com.au
info@territorylogistics.com.au
54 O'Sullivan Cct, East Arm NT 0822
0467 824 924
Registered Entity Name
Trading Name
ABN
ACN - if applicable
Trading Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Registered Office Address - if different from above

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Postal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Main Phone Number
Email
example@example.com
Business Commencement Date

MonthDayYear
Date
Accounts Details
Accounts Contact Name
Accounts Contact Phone
Accounts Contact Email
example@example.com
Do you require Purchas Order Numbers?

YesNo
Monthly Credit Limit Requested $
Name and Address of Directors / Owners / Proprietors - or attach Company List
1
2
Trade References - we do not accept fuel suppliers.
Name
Phone
Email
example@example.com
Years of Trade
Name
Phone
Email
example@example.com
Years of Trade
Name
Phone
Email
example@example.com
Years of Trade
Declaration and Agreement
I/We hereby apply for a credit account with Territory Logistic Solutions Pty Ltd ("the Company") and agree that:
1. I/We have read, understood and agree to be bound by the Company's Terms and Conditions of Trade (as amended from time to time), which form part of this Credit Application.
2. All invoices are payable strictly within the agreed trading terms, unless otherwise approved in writing by the Company.
3. The Company may, at its discretion, suspend or withdraw credit facilities at any time without notice.
4. I/We authorise the Company to make inquiries into the banking, trade and business references supplied, and to obtain credit information as permitted by law.
5. I/We acknowledge that in the event of default in payment, I/we shall be liable for all debt collection, legal and enforcement costs incurred by the Company.
6. The signatory warrants that they are duly authorised to execute this application on behalf of the applicant.
Name
Position
Date

MonthDayYear
Date
Signature

Clear
Territory Logistic Solutions Pty Ltd trading as Territory Logistics

ABN: 68 169 010 173

ACN: 169 010 173
Should be Empty:

Credit Application - Confidential