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Sample Credit Application

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Business contact information

Contact name:
Phone: Fax: E-mail:
Address:
City: State: Postcode:
In business since:
Sole trader:  Partnership:  Limited liability:  Other: 
Business and credit information
Postal address:
City: State: Postcode:
Telephone: Fax: E-mail:
Bank name:
Bank address: Phone:
City: State Postcode:
Business/trade references
Company name: Company name:
Contact name: Contact name:
Address: Address:
City: Postcode: City: Postcode:
Phone: Phone:
Fax: Fax:
E-mail: E-mail:
Company name: Company name:
Contact name: Contact name:
Address: Address:
City: Postcode: City: Postcode:
Phone: Phone:
Fax: Fax:
E-mail: E-mail:
Agreement
1. All invoices are to be paid as agreed and states on issued invoice.
2. Any claims arising from invoices must be made within five working days of receipt of invoice.
3. By submitting this application, you authorise Gutsii to make inquiries into the banking and
business/trade references that you have supplied.

Signatures

Title: Title:

Date: Date:

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