CUSTOMER INFORMATION

APPLICATION FOR CREDIT AND TERMS OF TRADE

I/We, as or on behalf of the applicant, apply for credit from Bulk Lines Ltd and agree to be bound by the attached Terms and Conditions.

Full Business Name

Name of Main Contact Person

Business Address - Postal

Business Address - Physical

Main Business Phone Number

Mobile

Email (1) [For Accounts Payable Contact]

Email (2) [For General Enquiries, Rate Change Notifications etc]

Nature of Business

Accountant

Expected average monthly cartage $

FULL CONTACT DETAILS OF ALL OWNERS / DIRECTORS / PARTNERS / TRUSTEES / INDIVIDUALS

1. Full Name:

1. Phone Number:

2. Full Name:

2. Phone Number:

3. Full Name:

3. Phone Number:

(1) FULL DETAILS OF TWO TRADE CREDIT REFERENCES (NO FUEL COMPANIES, BANKS, OR UTILITY SERVICE PROVIDERS)

(Note: Farmlands, PGG Wrightson, Farmsource & Ravensdown won’t give references, sorry)

Full Business & Contact Name:

Short answer

(2) FULL DETAILS OF TWO TRADE CREDIT REFERENCES (NO FUEL COMPANIES, BANKS, OR UTILITY SERVICE PROVIDERS)

(Note: Farmlands, PGG Wrightson, Farmsource & Ravensdown won’t give references, sorry)

Full Business & Contact Name:

Address & Phone Number:

Where this application for credit is from a Limited Liability Company, I/We the undersigned do jointly and severally give notice, that I/We agree to pay all the applicant company’s liabilities to the vendor should the company fail to pay such liabilities.

I/We the undersigned have read the attached terms and conditions and agree to abide by those said terms and conditions. I/We the undersigned have been given a completed copy of this credit application with the said terms and conditions attached.

SIGNED by the Applicant(s):

Date

Month

Day

Year

Print Full Name

Signature

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APPLICATION FOR CREDIT AND TERMS OF TRADE

I/We, as or on behalf of the applicant, apply for credit from Bulk Lines Ltd and agree to be bound by the attached Terms and Conditions.

Full Business Name

Name of Main Contact Person

Business Address - Postal

Business Address - Physical

Main Business Phone Number

Mobile

Email (1) [For Accounts Payable Contact]

Email (2) [For General Enquiries, Rate Change Notifications etc]

Nature of Business

Accountant

Expected average monthly cartage $

FULL CONTACT DETAILS OF ALL OWNERS / DIRECTORS / PARTNERS / TRUSTEES / INDIVIDUALS

1. Full Name:

1. Phone Number:

2. Full Name:

2. Phone Number:

3. Full Name:

3. Phone Number:

(1) FULL DETAILS OF TWO TRADE CREDIT REFERENCES (NO FUEL COMPANIES, BANKS, OR UTILITY SERVICE PROVIDERS)

(Note: Farmlands, PGG Wrightson, Farmsource & Ravensdown won’t give references, sorry)

Full Business & Contact Name:

Short answer

(2) FULL DETAILS OF TWO TRADE CREDIT REFERENCES (NO FUEL COMPANIES, BANKS, OR UTILITY SERVICE PROVIDERS)

(Note: Farmlands, PGG Wrightson, Farmsource & Ravensdown won’t give references, sorry)

Full Business & Contact Name:

Address & Phone Number:

SIGNED by the Applicant(s):

Date

Month

Day

Year

Print Full Name

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

APPLICATION FOR CREDIT AND TERMS OF TRADE

FULL CONTACT DETAILS OF ALL OWNERS / DIRECTORS / PARTNERS / TRUSTEES / INDIVIDUALS

ONLINE CREDIT APPLICATION FORM

APPLICATION FOR CREDIT AND TERMS OF TRADE

FULL CONTACT DETAILS OF ALL OWNERS / DIRECTORS / PARTNERS / TRUSTEES / INDIVIDUALS

Head Office/BOP

Napier

New Plymouth

Manawatu

Otorohanga

Nelson

Okaiawa