Commercial Credit Account

Please complete either [A], [B] or [C]
[A] COMPANY
Company Name
ACN
Trading As
ABN
Directors (1)
Directors (2)
Directors (3)
Directors (4)
Directors (5)
Directors (6)
Is there a Family or Discretionary Trust involved?
- Yes
- No
[B] PARTNERSHIP
Business name
ABN
Partner (1) name
Partner (1) address
Partner (2) name
Partner (2) address
Partner (3) name
Partner (3) address
[C] INDIVIDUAL - SOLE TRADER
Business name
ABN
Proprietors Name
Address
[D] ALL MUST COMPLETE
Business Details For*
- Company
- Partnership
- Sole Trader
Business Address*
Postal Address
Delivery Address
Phone*
Mobile
Fax
Email*
Web Address*
Registered Builders Number
Bank*
BSB*
Account Number*
How will you be paying you account*
- Cheque
- Direct Debit
- Cash
Note: Where possible notification of direct debit payment by fax, post or email is greatly appreciated
Trade Reference (1)*
Trade Reference (1) Phone*
Trade Reference (1) Fax*
Trade Reference (1) Contact*
Trade Reference (2)*
Trade Reference (2) Phone*
Trade Reference (2) Fax*
Trade Reference (2) Contact*
Trade Reference (3)*
Trade Reference (3) Phone*
Trade Reference (3) Fax*
Trade Reference (3) Contact*
Note: Dix Welding is unable to approve your account until we have received written reference from the suppliers that you elect above. A direct accounts contact name, along with correct contact details will ensure fast approval of your account.
Contact (1)
Contact (1) Position
Contact (1) Phone
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