7 DAY CREDIT ACCOUNT APPLICATION Please complete this form below or download the PDF. This application takes around 15 minutes to complete. "*" indicates required fields Step 1 of 6 16% This field is hidden when viewing the formUser Role*Applicant DetailsRegistered Business Name*Trading Name(s)ABN/ACN*Business Type* Sole Trader Partnership Company (Pty Ltd) Trust Other Registered Business Street Address*Suburb*Postcode*State*StateVICNSWQLDSAWATASACTNTPrinciple Business Activity*No. of Years Trading* Billing DetailsBilling Street Address*Suburb*Postcode*State*StateVICNSWQLDSAWATASACTNTContact Name*Position*Mobile Phone* (this number will receive important SMS updates about your orders) Mobile Phone (for SMS updates)*Landline PhoneEmail* Accounts PayableContact Name*Phone*Email* Delivery DetailsDelivery Street Address*Suburb*Postcode*State*StateVICNSWQLDSAWATASACTNTDelivery Contact Name*Phone*Email* Delivery Hours*Delivery Instructions If you have registered as a Company (Pty Ltd), please provide details for at least 2 authorised representatives, directors or principals. Authorised Representative 1Frist Name*Last Name*Residential Street Address*Suburb*Postcode*State*StateVICNSWQLDSAWATASACTNTPhone*Email* Date of Birth MM slash DD slash YYYY Driver’s License No.*Driver's License State of Issue*StateVICNSWQLDSAWATASACTHave you ever been bankrupt, or been an owner/director of a business that was liquidated?* Yes No Authorised Representative 2Frist NameLast NameResidential Street AddressSuburbPostcodeStateStateVICNSWQLDSAWATASACTNTPhoneEmail Date of Birth MM slash DD slash YYYY Driver’s License No.Driver's License State of IssueStateVICNSWQLDSAWATASACTHave you ever been bankrupt, or been an owner/director of a business that was liquidated? Yes No Authorised Representative 3Frist NameLast NameResidential Street AddressSuburbPostcodeStateStateVICNSWQLDSAWATASACTNTPhoneEmail Date of Birth MM slash DD slash YYYY Driver’s License No.Driver's License State of IssueStateVICNSWQLDSAWATASACTHave you ever been bankrupt, or been an owner/director of a business that was liquidated? Yes No Please list the names of 3 companies who you have traded with for a minimum of 12 months and who is happy for us to contact as a trade reference. Trade Reference 1Company Name*Contact Name*Phone*Email* Address*Trade Reference 2Company Name*Contact Name*Phone*Email* Address*Trade Reference 3Company Name*Contact Name*Phone*Email* Address* AuthorisationAgreement to Terms of Trade* I agree to our Terms and Conditions of TradeBy ticking this box, you confirm you have read and agree to The Paper Pack Company’s Terms and Conditions of Trade and will ensure relevant staff are aware of these Terms. 7-Day Account* Acknowledgement of Payment TermsI acknowledge that this account is offered on 7-day payment terms and agree that all invoices are payable within seven (7) days from the invoice date. Failure to make payment within this period may result in the account being placed on hold and orders withheld until payment is received. Privacy Consent* I authorise The Paper Pack Company to;• Obtain and retain any information necessary to assess this application or manage the account;• Make enquiries with trade references, credit reporting agencies and financial institutions;• Disclose credit information to third parties for the purpose of credit assessment, account administration or debt recovery.Authorised Signatory* I confirm that I am authorised to sign this application on behalf of the ApplicantFirst Name*Last Name*Position*Date* DD slash MM slash YYYY Signature*CAPTCHA
