Credit Account Application

EBE SUNCOAST PTY LTD - ACN: 108122194

The Company and the Client named below understand this is a contract comprising the credit application and the Company’s terms and conditions. New customers are COD. Approved credit accounts are 7 days from invoice unless otherwise stated. Payment terms are confirmed when booking the job.

I/We hereby apply for a Credit Account and submit the following information

Business Name Email Address

Trading Address Trading Suburb / Post Code

Postal Address Postal Suburb / Post Code

Business Phone Business Fax Mobile ABN

Nature of Business Approx. Number of Employees Date Business Commenced

Bank Name Branch

Business Structure

Sole Trader / Partnership Company / Incorporated Association Trust

Sole Trader / Partnership

Registered Trading Name Registered Business No. / ABN State of Registration

Personal details of all registered proprietors of the trading name. If more than 3, add details in the notes section below.

Proprietor 1

Full Name Home Phone Date of Birth Post Code

Residential Address

Proprietor 2

Full Name Home Phone Date of Birth Post Code

Residential Address

Proprietor 3

Full Name Home Phone Date of Birth Post Code

Residential Address

Company / Incorporated Association

Type Registered Name ACN

Date of Incorporation State of Incorporation

A Director/Personal Guarantee and Indemnity may be required before credit is approved and should be signed by all directors/guarantors required by EBE.

Trust

Registered Trust Name Trust Type

Trustee

Address for Trustee Suburb / Post Code

Credit Details

Estimated Amount of Credit per Month Requested Credit Limit

Persons to contact regarding payment of the account

Contact 1 Name Position Phone

Contact 2 Name Position Phone

Authorised Ordering Controls

Authorised buyers / contacts Approved delivery / service addresses

Purchase Order Required? PO / Reference Requirements

Trade References

Please list three trade references with which you have a credit account. By listing a reference you authorise EBE to contact them to discuss your trading history and verify your details.

Trade Reference 1

Business Name Date Account Opened

Contact Name Phone Email / Fax

Trading Address / Post Code

Trade Reference 2

Business Name Date Account Opened

Contact Name Phone Email / Fax

Trading Address / Post Code

Trade Reference 3

Business Name Date Account Opened

Contact Name Phone Email / Fax

Trading Address / Post Code

Director / Guarantor Details, if requested by EBE

These details help EBE prepare any required Director/Personal Guarantee and Indemnity. EBE may still require a separate signed guarantee or further identity checks before approving credit.

Director / Guarantor 1

Full Legal Name Date of Birth Phone

Email Residential Address

Director / Guarantor 2

Full Legal Name Date of Birth Phone

Email Residential Address

Director / Guarantor 3

Full Legal Name Date of Birth Phone

Email Residential Address

Declaration and Authority

I/We declare and warrant that the applicant/s are neither bankrupt nor insolvent, have not traded while insolvent in the previous 3 years, and have disclosed any material credit or solvency issue. I/We authorise trade reference, credit, financial, PPSR and guarantor checks required to assess, administer and collect this account, and consent to the collection, use and disclosure described in the Privacy and Credit Reporting Collection Notice. I/We declare that the credit applied for and any Goods/Equipment supplied on credit are for business or commercial purposes, not personal, domestic or household purposes or residential investment purposes. I acknowledge and warrant that I am duly authorised to sign and make this application on behalf of the applicant/client.

Terms and Conditions Download and Agreement

The Terms and Conditions download is compulsory. The I agree checkbox will remain unavailable until the download link has been clicked and recorded.

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I agree to the EBE Suncoast Pty Ltd General Terms and Conditions of Trade, Privacy and Credit Reporting Collection Notice, repair notice, equipment hire provisions and payment terms.

The system stores the terms version, document hash, download timestamp, agreement timestamp, IP address, user agent and anti-spam/security evidence with the submitted application.

Electronic Signature

By typing your full name and submitting this form, you sign this application electronically and acknowledge that EBE may rely on this submission as your authority.

Full Name of Signatory Position / Capacity

Signatory Email Signatory Phone

Additional notes or instructions

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Credit Application

Credit Account Application

I/We hereby apply for a Credit Account and submit the following information

Business Structure

Sole Trader / Partnership

Proprietor 1

Proprietor 2

Proprietor 3

Company / Incorporated Association

Trust

Credit Details

Persons to contact regarding payment of the account

Authorised Ordering Controls

Trade References

Trade Reference 1

Trade Reference 2

Trade Reference 3

Director / Guarantor Details, if requested by EBE

Director / Guarantor 1

Director / Guarantor 2

Director / Guarantor 3

Declaration and Authority

Terms and Conditions Download and Agreement

Electronic Signature