New Customer Credit Account / 14 Days

Please forward for processing to: accounts@afsigns.com.au

08 9456 1414

CUSTOMERS DETAILS

Trading Name / Applicant

Legal Entity (if different from trading name)

Industry

No. of Staff

ACN

ABN* (An 11 digit ABN must be provided)

Proprietor's Name/s if a sole Trader or Partnership

Date of Birth required for Creditcheck

Registered Office Address

Suburb

State

Postcode

Postal Address

Suburb

State

Postcode

Accounts Landline Tel. No.

Accounts Fax No.

Accounts Email

Receive Statements

Delivery Address (no PO box)

Suburb

State

Postcode

Tel. No.

Fax No.

Details of Relevant Contacts

First Name

Last Name

Job Title

Email Address

CUSTOMER'S TRADE REFERENCES

1. Commercial Supplier:

Contact

Telephone

Address

2. Commercial Supplier:

Contact

Telephone

Address

CUSTOMER'S SIGNATURE

By signing this Application, the Customer hereby accepts Iona Global Pty Ltd t/as Advanced Fleet Signs Terms and Conditions of Credit and Terms and Conditions of Sale - which is available upon request.

Signed for and on behalf of the applicant:

Signature

Date

Name (Please use BLOCK CAPITALS)

Position

Iona Global Pty Ltd t/as Advanced Fleet Signs ABN: 57 157 918 011

FOR OFFICE USE ONLY

Sales Representative: _______________________________

Rep Code:_________________________________________

Department:________________________________________

Credit Admin Approval:_______________________________

Credit Limit:____________________Date:______________