Credit Application

Step 1 of 3

Business Contact Information

Company Name(Required)

Trading As:

Company Website:

ABN:(Required)

Accounts Contact Name:

Accounts Phone Number:(Required)

Accounts Email:(Required)

Purchasing Manager:(Required)

Purchasing Phone Number:(Required)

Purchasing Email:(Required)

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Physical Address same as Billing Address?

Yes

Physical Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Payment Method:(Required)

Credit Line Requested:(Required)

Bank Name(Required)

Account Number:(Required)

Bank Contact:(Required)

Phone:(Required)

Bank Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Nature of Account:

Trade References

Please provide at least three references

Reference 1

Company Name:(Required)

Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone:

Email(Required)

Reference 2

Company Name:(Required)

Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone:

Email:(Required)

Reference 3

Company Name:(Required)

Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone:

Email:(Required)

Reference 4

Company Name:(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email:(Required)

Agreement

Consent(Required)

I hereby authorise the release of any banking information to Delta Automation or its authorised assignees.

TERMS AND CONDITION OF SALE

1. Definitions
a. In these condition of Sale:
i.“the Company” means Delta Automation.
ii.“The Customer” means the person, firm or Company ordering the services from the Company.
iii.“the Goods and/or Services”: means goods and services for all forms of interpreting, translation of documents, training, multilingual information lines, cross-cultural and bi-cultural consultancy and all other services provided by the Company to the Customer.
b. These conditions shall apply to, and be incorporated into, every agreement between the Company and the Customer under which the Company supplies goods and/or services at the request of the Customer.
c. Any quotation and agreement between the Company and the Customer shall in all respects be governed by, and construed in accordance with, Australian law and the Courts of Australia shall have jurisdiction to hear all disputes arising in connection with the goods and/or services.
d. Unless otherwise specifically stated, any prices quoted by the Company are stated in the Company’s schedule of fees and are in Australian currency and the company shall charge extra in respect of such items.
2. Price
a. Unless otherwise specifically stated, any prices quoted by the Company are stated in the Company’s schedule of fees, and are in Australian currency and the company shall charge extra in respect of such items.
3. Payment
a. Credit terms are subject to the acceptance of this Credit Application, and validation of trade references, and are strictly agreed as 30 days net from the date of invoice.
b. In the event that payment shall not have been made by such date, the Company shall be entitled to recover the outstanding amount and the Customer will pay all collection costs including, but not limited to, legal expenses and debt collection commission incurred to obtain payment for any amounts owing to the Company in respect of the goods and/or services provided.
c.The granting of any credit by the Company to the Customer shall be at the Company’s absolute discretion and may be revoked at any time whereupon any and all amounts owing to the Company shall be paid immediately.

Consent 2

I hereby authorise the release of any banking information to Delta Automation or its authorised assignees.

Signature(Required)

Print Name(Required)

Date(Required)

Title:(Required)

Credit Application

Business Contact Information

Trade References

Reference 1

Reference 2

Reference 3

Reference 4

Agreement

TERMS AND CONDITION OF SALE

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