Forwarding Direct



Forwarding Direct Ltd,11 Mayo Rd,Wiri, Auckland 2104Tel: +64 9 909 71857200900114300APPLICATION FOR CREDIT ACCOUNT WITH FORWARDING DIRECT LTD NEW ZEALANDPrint and complete manually, or TAB through items to complete on computer. Click checkboxes to select.Items marked with an asterisk* are pany DetailsApplicant's Full Legal Name:*(i.e. not trading name) FORMTEXT ?????GST No. :* FORMTEXT ?????Importer Code:* FORMTEXT ?????Deferred:* FORMCHECKBOX Yes FORMCHECKBOX NoType of company:* FORMCHECKBOX Sole Trader FORMCHECKBOX Individual FORMCHECKBOX Partnership FORMCHECKBOX Ltd Company FORMCHECKBOX OtherIf 'Other', please specify: FORMTEXT ?????Trading as:* FORMTEXT ?????Postal address:* FORMTEXT ?????Physical address:* FORMTEXT ?????Nature of business:* FORMTEXT ?????Years in business:* FORMTEXT ?????Business Contact DetailsTelephone:* FORMTEXT ?????Email:* FORMTEXT ?????Fax: FORMTEXT ?????Contact name:* FORMTEXT ?????Contact position:* FORMTEXT ?????OwnershipOwner(s)' / Director(s)' names in full:1. Owner/director name:* FORMTEXT ?????1. Address:* FORMTEXT ?????2. Owner/director name: FORMTEXT ?????2. Address: FORMTEXT ?????3. Owner/director name: FORMTEXT ?????3. Address: FORMTEXT ?????If limited liability -Address of Registered Office: FORMTEXT ?????Date of incorporation: FORMTEXT ?????Affiliated/Parent companies: FORMTEXT ?????Financial Capital, Authorised: $ FORMTEXT ?????Paid up: $ FORMTEXT ?????Securities over Business Assets: FORMTEXT ?????Name of Accountant: FORMTEXT ?????Solicitor: FORMTEXT ?????Bank:* FORMTEXT ?????Branch:* FORMTEXT ?????Account number:* FORMTEXT ?????Credit References:Please exclude Credit Card and Finance companies,Airlines, Power Authorities, Telecom, Clear, Landlords,Banks, Lawyers, Accountants or Industry Competitors1. Reference name:* FORMTEXT ?????1. Telephone:* FORMTEXT ?????2. Reference name: FORMTEXT ?????2. Telephone: FORMTEXT ?????3. Reference name: FORMTEXT ?????3. Telephone : FORMTEXT ?????1. I/We have read and agree to be bound by Forwarding Direct Ltd (“Forwarding Direct”) current terms and conditions of trade including all future changes, alterations and substitutions which may apply from time to time. I/We further acknowledge notification of all such changes, alterations and substitutions shall be made in writing by Forwarding Direct and shall be deemed to be delivered, received and accepted by me/us five days after posting to the last known mailing address of me/us held by Forwarding Direct.2. PRIVACY ACT CONSENT – I/We irrevocably authorize Forwarding Direct at any time to obtain from any person or company any information (including a credit report), which Forwarding Direct may require for credit reference purposes. I/We further irrevocably authorize Forwarding Direct to provide to any third party in response to credit reference and enquiries about me/us or by way of information exchange with credit reference agencies, details of this application and any subsequent dealings (including adverse information) that I/We may have with Forwarding Direct as a result of this application being actioned by Forwarding Direct.3. I/We further acknowledge that the above information is to be used by Forwarding Direct for all credit purposes in connection with Forwarding Direct considering this application and the subsequent operation of the account by me/us once approved including: To assess my/our client credit worthiness including my/our position if I/we fall in arrears To assist me/us to avoid defaulting on my our credit obligations To notify other credit providers of a default by me/us4. I/We warrant to The Company that the above information is to the best of my knowledge and belief true and correct and that I am duly authorized to enter this application and future contracts on the applicants/purchaser’s behalf.As the applicant I certify that I have read and accepted these terms and conditions: FORMCHECKBOX Name:* FORMTEXT ?????Date and Place:* FORMTEXT ?????Designation:* FORMTEXT ?????Signature:* Please insert signature image here, or print and sign, before submitting Credit Application ................
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