CREDIT ACCOUNT APPLICATION

Please, make sure all relevant questions are fully answered and your details are correct.

THE APPLICANT IDENTIFIED BELOW REPRESENTS AND WARRANTS TO IL CASARO LTD. THAT THIS INFORMATION IS TRUE AND CORRECT TO THE BEST OF ITS KNOWLEDGE. IT IS ACKNOWLEDGED BY THE APPLICANT (OR THE UNDERSIGNED ON BEHALF OF THE APPLICANT) THAT THE TERMS AND CONDITIONS OF APPLICATION FOR CREDIT ACCOUNT AND INVOICE CONDITIONS AS PROVIDED WITH THIS APPLICATION HAVE BEEN READ, UNDERSTOOD AND ACCEPTED AND THAT SUCH TERMS AND CONDITIONS APPLY TO ALL GOODS SUPPLIED BY IL CASARO LTD. TO THE APPLICANT. CREDIT IS APPROVED SUBJECT TO THESE REPRESENTATIONS AND WARRANTIES AND AT THE DISCRETION OF IL CASARO LTD. AND MAY BE WITHDRAWN AT ANY TIME.

BUSINESS DETAILS

Trading Name*

Legal Name*

Date of Incorporation*

Business no. (NZBN)

GST no.

Registered Address*

City (RA)*

Postcode (RA)*

Postal Address*

City (PA)*

Postcode (PA)*

Delivery Address*

City (DA)*

Postcode (DA)*

Main Contact

First Name (C)*

Last Name (C)*

Email (C)*

Phone (C)*

DIRECTORS / SHAREHOLDERS / TRUSTEES DETAILS

Name 1*

Address 1*

DOB 1*

Name 2

Address 2

DOB 2

Name 3

Address 3

DOB 3

ACCOUNT DETAILS

Type of business*

Years in business

Req. Credit Limit

Accounts Payable

First Name (A)*

Last Name (A)*

Email (A)*

Phone (A)*

Bank References

Trading Bank Name*

Branch Address

Bank Contact Person

Email (B)

Phone (B)

TRADE REFERENCES

Referee 1

Company Name (R1)

Address (R1)

Contact Name (R1)

Email (R1)

Phone (R1)

Referee 2

Company Name (R2)

Address (R2)

Contact Name (R2)

Email (R2)

Phone (R2)

USERNAME and PASSWORD

Choose a username and password of your choice. Remember, the username cannot be changed.

Username*

Password*