Adelaide
11 - 13 Opala Street, Regency Park, South Australia 5010 Australia
Brisbane
14/65 Christensen Road, Stapylton, Queensland 4207 Australia
Phone: (08) 8243 0233
International Phone: + 61 8 8243 0233
Email: [email protected]
Fax: (08) 8243 1744
International Fax: + 61 8 8243 1744
Internet: www.sienafoods.com.au
CREDIT APPLICATION AND SECURITY AGREEMENT
Registered
Company Name:
Trading Name:
ABN:
ACN:
Physical Address:
Postal Address:
Please Indicate:
Company Partnership Sole Prop. Govt.Dept Trustee Co ** see below
Telephone:
Mobile Phone: Email:
Accounts Contact Name:
Nature of Business:
How long in this Business:
Purchase Order Number Required:
YES NO
Estimated Monthly Purchases: $
Full name and residential addresses of all the Directors/Partners/Proprietors: (Please attach a separate page if insufficient space)
Name Residential Address Drivers License No. Date of Birth
Name Residential Address Drivers License No. Date of Birth
Please provide a minimum of three trade credit references:
Company Name Contact Name Telephone No.
This agreement constitutes a Security Agreement pursuant to the Personal Property Securities Act 2009 (PPSA)
•
Completing a Credit Application does not infer that credit will be granted.
•
The document must be completed in full with no alterations or deletions. Any such alterations or deletions will void the application and a new form will have to
be completed.
•
The Company reserves the right to refuse credit to any Applicant without explanation.
•
The Company reserves the right to suspend or withdraw credit facilities at any time without notice.
•
**Special Note: if the Company acts as, or is part of, a Trust/Nominee company then the provision of personal guarantee/s from the Trust
Beneficiary/Beneficiaries is required to process this application.
OFFICE USE ONLY
Sales Representative to indicate customers preferred trading terms: Letter Sent – Dated…………………..
□
30 days
□
14 days
□
7 days - Advising Trading Terms
- Copy of Terms & Conditions
SALES REP I.D: APPROVED: DECLINED:
- Copy of Privacy Statement
SHORT CODE:………………………
S
I
E
N
A
F
O
O
D
S
P T Y
L T D