Envirotek

PERSONAL INFORMATION

(Same as above)

Business Structure

1.COMPANY / INCORPORATED ASSOCIATION

TYPE :

2.SOLE TRADER / PARTNERSHIP

Personal details of all registered proprietors of the trading name:

3.TRUST

TRADE REFERENCES

Signature

DECLARATION BY/FOR AND ON BEHALF OF THE APPLICANT/S / CLIENT (Please read carefully before signing)

1. I/We declare and warrant that the applicant/s are neither bankrupt nor insolvent and have not committed any act of bankruptcy nortraded whilst insolvent within the previous 3years.
2. I/We authorise the Seller to conduct such credit and financial checks on the Buyer (and any guarantors) as deemed necessary at anytime, and consent to such checks for the purposes of the Privacy Act 1988 (Cth), and consent to disclosure of such information to acredit reporting or recovery agents.
3. I/We acknowledge and agree to the General Terms & Conditions of Trade that are to be read in conjunction with this Application forCredit and agree to be bound by the General Terms and Conditions of Trade upon signing the document.
4. I/We acknowledge that the Buyer and each of the Guarantors have received a complete and legible copy of this Agreement andTerms and Conditions before signing it.
5. I acknowledge and warrant that I am duly authorised to sign and make this application.

Currently physically on file

Signature of Applicant # 1

I witnessed Applicant # 1 sign this document on the date indicated:

Clear Signature

Signature of Applicant # 2

I witnessed Applicant # 2 sign this document on the date indicated:

Clear Signature

I/We acknowledge that I/we have read and understood the contents of these terms and conditions

Signature of Applicant # 1

Signature of Applicant # 2

Clear Signature

Login Details

Agree with Terms And Condition

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