Credit Application Form

Business Credit Application

Personal Information
Name of Applicant*

First NameLast Name
E-mail of Applicant*
Business Phone*

Area CodePhone Number
Mobile Phone*

Area CodePhone Number
Fax Number

Area CodePhone Number
Residensial Personal Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Partnership Detalis
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1. Details of Partner*

Full Name

Address

CityState / Province

Postal / Zip CodeCountry
Do you have any more partner in your business?

NoYes
2. Details of Partner*

Full Name

Address

CityState / Province

Postal / Zip CodeCountry

Trade References:
Excluding Credit Cards, Fuel Suppliers, Landlord, Power & Phone
1. Company Name*
Reference Name*

First NameLast NameTelphone Number
2. Company Name*
Reference Name*

First NameLast NameTelphone Number
3. Company Name*
Reference Name*

First NameLast NameTelphone Number

Business Credit Application

Financial Information
Does the borrower have an up to date assets and liabilities statement?*

YesNo
Has your business been financed or given credit before?*

YesNo
Lender Name
Financing was for

Business Credit Application

Submit my Application
The information provided in this application shall not be shared to anyone else and is kept confidential
I agree that the information herein are true and correct and giving my credit card as security if any amount is over due more than 10 days, I will authorise Express Contracting Services to withdrew total amount outstanding for that period*

Yes

Your Business Credit Card Number*

Business Credit$150.00AUD

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Trading Terms
I/We hereby state that the facts given above are true and correct and understand that approval of credit facility will be based upon the information given and that upon receiving the facility of a Credit Account. I/We will pay for all goods and services received before the end of the calendar month after the date of purchase and guarantee that payment will be made for all charges made on this account. I/We agree to Trading Terms as per reverse side of Credit Application. I/We agree to advise Express Contracting Services P/L TA Golden Brown Cleaning Supplies & Machinery of any changes in our operation or ownership and understand that where ownership changes and not written advice is given the original applicant is liable for payment of any amounts.

SETTLEMENT:

Two and One Half Percent (2.5%) settlement discount applies to all invoices paid within seven (7) days of invoice date (Condition Applies). Otherwise strictly Net Thirty (30) days.

CONDITION OF SALE:

All goods are supplied on the condition they remain the sole property of the company until paid for full. However, the goods are at the purchasers risk upon delivery.

GUARNTEE:

All goods distributed by GBCS&M are fully guaranteed against faulty workmanship and materials, But not maltreatment. Any goods which in our opinion are defective will be exchanged, provided they are returned to us within thirty (30) days, freight paid. No claims can be considered for consequential damage or labour entailed.

CLAIMS:

No claims will be processed after three (3) days. Invoice number, date and reason for claim must be stated on claim form. No refund, exchange of goods only.

PRICES:

Prices are subjected to change without notice; All prices are Exclusive GST.

FREIGHT:

Basic Charge is $15.00 Metro Capital Cities + GST if total purchase is less than $450.00, otherwise free of charge (Condition Apply)

I certify that the above information is true and correct and that I am authorised to make this application for credit. In accordance with the

Privacy Act (1988) 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 (overleaf) of The Giant Trust Group ATF Express Contracting

Services T/A Golden Brown Cleaning Supplies & Machinery which form part of, and are intended to be read in conjunction with this

Authorisation To Supply Form and agree to abide by these conditions.
Signature of Applicant*
Signature of Second Partner in 1. Details of Partner*
Signature of Third Partner in 2. Details of Partner*
Signature of Witness*
Full Name of Witness*

First NameLast Name
Relation*

Personal/Directors Guarantee And Indemnity
Personal/Directors Guarantee And Indemnity

IN CONSIDERATION of The Giant Trust Group ATF Express Contracting Services T/A Golden Brown Cleaning Supplies & Machinery and its successors and assigns (“the Seller”) at the request of the Guarantor (as is now acknowledged) supplying and continuing to supply goods and/or services to (“the Buyer”)

I/WE UNCONDITIONALLY AND IRREVOCABLY:
1. GUARANTEE the due and punctual payment to the Seller of all moneys which are now owing to the Seller by the Buyer and all further sums of money from time to time owing to the Seller by the Buyer in respect of goods and services supplied or to be supplied by the Seller to the Buyer or any other liability of the Buyer to the Seller, and the due observance and performance by the Buyer of all its obligations contained or implied in any contract with the Seller. If for any reason the Buyer does not pay any amount owing to the Seller the Guarantor will immediately on demand pay the relevant amount to the Seller.
2. HOLD HARMLESS AND INDEMNIFY the Seller on demand as a separate obligation against any liability (including but not limited to damages costs losses and legal fees (as defined hereunder in paragraph b hereof)) incurred by or assessed against the Seller in connection with:
(a) the supply of goods and/or services to the Buyer; or

(b) the recovery of moneys owing to the Seller by the Buyer including the enforcement of this guarantee, and including but not limited to the Seller’s

nominees costs of collection and legal costs calculated on a solicitor and own client basis; or

(c) moneys paid by the Seller with the Buyer’s consent in settlement of a dispute that arises or results from a dispute between, the Seller, the Buyer, and

a third party or any combination thereof, over the supply of goods and/or services by the Seller to the Buyer.

I/WE FURTHER ACKNOWLEDGE AND AGREE THAT
1. This Guarantee and Indemnity shall constitute an unconditional and continuing guarantee and indemnity and accordingly shall be irrevocable and remain in full force and effect until the whole of moneys owing to the Seller by the Buyer and all obligations herein have been fully paid satisfied and performed.
2. No granting of credit, extension of further credit, or granting of time and no waiver, indulgence or neglect to sue on the Seller’s part (whether in respect of the Buyer or any one or more of any other guarantor(s) or otherwise) and no failure by any named guarantor to properly execute this Guarantee and Indemnity shall impair or limit the liability under this Guarantee and Indemnity of any guarantor. Without affecting the Buyer’s obligations to the Seller, each guarantor shall be a principal debtor and liable to the Seller accordingly.
3. If any payment received or recovered by the Seller is avoided by law such payment shall be deemed not to have discharged the liability of the Guarantor, and the Guarantor and the seller shall each be restored to the position in which they would have been had no such payment been made.
4. This Guarantee and Indemnity shall bind each of the signatories notwithstanding that one or more of the persons named as a “Guarantor” may never execute this Guarantee and Indemnity.
5. The term “Guarantor” whenever used in this Guarantee and Indemnity shall, if there is more than one person named as guarantor, mean and refer to each of them individually and both of them together unless the context otherwise requires, and the obligations and agreements on the part of the guarantor contained in this guarantee and Indemnity shall bind them jointly and severally.
6. I/We have been advised to obtain independent legal advice before executing this Guarantee but have either waived or declined to take independent legal advice. I/we understand that I/we am/are liable for all amounts owing (both now and in the future) by the Buyer to the Seller.
7. The above information is to be used by the Seller for all purposes in connection with the Seller considering this guarantee and the subsequent enforcement of the same.
8. I/we irrevocably authorise the Seller to obtain from any person or company any information which the Seller may require for credit reference purposes.
I/We further irrevocably authorise the Seller to provide to any third party, in response to credit references and enquiries about me/us or by way of

information exchange with credit reference agencies, details of this Guarantee and Indemnity and any subsequent dealings that I/we may have with the

Seller as a result of this guarantee being actioned by the Seller.
Signature of Guarantors*
Full Name of Gurantors*

First NameLast Name
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Business Credit Application

Business Credit Application

Partnership Detalis

Business Credit Application

Business Credit Application

Trading Terms

Personal/Directors Guarantee And Indemnity