New Customer Application

WHEN TO USE THIS FORM: 1. You are not yet a Webvault customer and are applying for your first Webvault product or service. 2. You need to provide Webvault with your company and billing information.

Need Help with this Form?Call 1300 139 927 (Option #1) Email: sales@webvault.com.auWeb: www.webvault.com.au

Company Information

Registered Company or Business Name:*

Your ABN or Business Reg #*

Name of Company Director (or Principal)*

Directors Email Address*

Place of Business (Street Address)*

Suburb*

Postcode*

State*

Business Phone*

Company Website

Billing Information

NOTE: Your billing address will appear on the top of your invoice from Webvault, however all account invoices will be sent via email.

Billing Address*

Suburb*

Postcode*

State*

Billing Email address*

Accounts Payable Phone*

Authorised Account Contacts

For security purposes you must specify the authorised contacts for your account. The persons listed below will have authority to request information and make changes in relation to services on your account.

Contact Person #1*

Mobile Phone*

Email Address*

Contact Person #2

Mobile Phone

Email Address

Contact Person #3

Mobile Phone

Email Address

Trade References

NOTE: Trade references are only required when the total value of your Webvault services are expected to exceed $1000/Month.

Business Name #1

Phone Number

Email

Business Name #2

Phone Number

Email

Additional Information

General Terms & Conditions By submitting this application I understand and agree to the following terms: 1. Payment terms for all service charges are 14 days from the date of invoice, unless otherwise pre-approved by our credit team.2. All fixed monthly charge services on your account are payable in advance of the service term.3. Cancellation of services must be in writing with at least 21 days written notice and accompanied by a Webvault Service Cancellation Request form.4. You will contact Webvault in the event that any of the company or contact information on this form should require updating.5. Webvault services are only available to actively registered businesses and organisations.

Application Authorisation*

I hereby certify that all the details I have entered above are correct and that I am duly authorised by the Company or business to sign this application on its behalf and agree to the above general terms and conditions.

Signed*

Date*

Date

Position*

Applicant Email Address*